CC Group Home Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CC GROUP HOME CARE INC

Practice address

3633 Columbus Avenue
Minneapolis, MN 55407

Phone

(612) 387-3039

NPI assigned

Nov 30, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fowsiya Abdihamid Hassan

Title

Owner

Phone

(612) 387-3039

Specialties & licenses 5

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605398400000",
    "number": "1982241782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 COLUMBUS AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-387-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 COLUMBUS AVENUE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-387-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CC GROUP HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-30",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "FOWSIYA",
        "authorized_official_middle_name": "ABDIHAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-387-3039"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.