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ACACIA GROVE ASSISTED LIVING LLC
NPI 1063219640
Assisted Living Facility in Burnsville, MN

Active since February 28, 2025CLIA 24D2334605 · Waiver
13416 PENN AVE S, BURNSVILLE, MN 55337(952) 228-1187 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Acacia Grove Assisted Living Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACACIA GROVE ASSISTED LIVING LLC (NPI 1063219640) is a healthcare organization registered as an assisted living facility in Burnsville, Minnesota and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through November 24, 2027 and lists Hafsa Ahmad, Director, as its authorized official.

NPPES Registry Identity

NPI1063219640
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameACACIA GROVE ASSISTED LIVING LLC
Location Address13416 PENN AVE SBurnsville, MN 55337-2021
Mailing Address13416 Penn Ave SBurnsville, MN 55337-2021 · (952) 228-1187
Phone(952) 228-1187
Organization SubpartNo
Authorized OfficialHafsa AhmadDirector · (952) 228-1187
Enumeration DateFebruary 28, 2025
Last NPPES UpdateJuly 24, 2025
NPPES CertifiedJuly 24, 2025
✔ NPI 1063219640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

13416 PENN AVE S, Burnsville, MN 55337
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2334605

Acacia Grove Assisted Living LLC · Burnsville, MN
Active · expires Nov 24, 2027
CLIA Number24D2334605
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 25, 2025
Certificate Expiration DateNovember 24, 2027
Laboratory DirectorHafsa M. Ahmad
Laboratory Phone(952) 228-1187
Laboratory LocationAcacia Grove Assisted Living LLC13416 Penn Avenue S, Burnsville, MN 55337
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Acacia Grove Assisted Living LLC's NPI number?

The NPI number for Acacia Grove Assisted Living LLC is 1063219640. It was assigned to this organization in the NPPES registry on February 28, 2025.

Where is Acacia Grove Assisted Living LLC located?

Acacia Grove Assisted Living LLC is located at 13416 Penn Ave S, Burnsville, MN 55337. The listed phone number is (952) 228-1187.

What is Acacia Grove Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Acacia Grove Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2334605) is associated with this NPI, valid through November 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Acacia Grove Assisted Living LLC was last updated on July 24, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.