OrganizationActive
Prime Living Mn LLC
NPI 1376496612 · Assisted Living Facility (Behavioral Disturbances) · Eagan, MN
Provider details
- NPI number
- 1376496612
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Behavioral Disturbances)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Mohamed I Mouhoumed, Owner(443) 310-0126
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
2110 Wuthering Heights Rd
Eagan, MN 55122-1028
Phone: (443) 310-0126
Approximate (ZIP-level) locationGet directions
Mailing address
2110 Wuthering Heights Rd
Eagan, MN 55122-1028
Registry dates
- Enumerated
- 2026-02-17
- Last updated
- 2026-02-17
- Certified
- 2026-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.