OrganizationActive
Northeastern Home Group LLC
NPI 1871344523 · Assisted Living Facility (Mental Illness) · Minnetonka, MN
Provider details
- NPI number
- 1871344523
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Fadumo Jama, Director(612) 203-2394
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
10255 Greenbrier Rd Apt 122
Minnetonka, MN 55305-3425
Phone: (952) 209-4046
Approximate (ZIP-level) locationGet directions
Mailing address
716 County Road 10 Ne Apt 234
Blaine, MN 55434-2331
Registry dates
- Enumerated
- 2024-04-01
- Last updated
- 2025-08-12
- Certified
- 2025-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.