IndividualActive
Idman Omar
NPI 1992633903 · Adult Care Home Facility · Lakeville, MN
Provider details
- NPI number
- 1992633903
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
5378 178th St W
Lakeville, MN 55044-5180
Phone: (507) 202-4730
Approximate (ZIP-level) locationGet directions
Mailing address
5378 178th St W
Lakeville, MN 55044-5180
Registry dates
- Enumerated
- 2026-05-11
- Last updated
- 2026-05-11
- Certified
- 2026-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.