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NEW LIFE HOME LLC
NPI 1063279834
Assisted Living Facility in Apple Valley, MN

Active since February 28, 2024CLIA 24D2269366 · Waiver
15300 DUNDEE CT, APPLE VALLEY, MN 55124(612) 441-2030(612) 545-1758 Get Directions Write a Review

NPPES record last updated: April 7, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About New Life Home Llc NPPES

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

NEW LIFE HOME LLC (NPI 1063279834), doing business as New Life Home, is a healthcare organization registered as an assisted living facility in Apple Valley, Minnesota and active in the NPI registry since February 2024. The organization holds a CLIA Waiver certificate valid through September 25, 2026 and lists Miressa Jibalo, Owner, as its authorized official.

NPPES Registry Identity

NPI1063279834
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameNEW LIFE HOME LLC
Location Address15300 DUNDEE CTApple Valley, MN 55124-5887
Mailing Address15300 Dundee CtApple Valley, MN 55124-5887 · (612) 441-2030 · Fax (612) 545-1758
Phone(612) 441-2030
Fax(612) 545-1758
Organization SubpartNo
Authorized OfficialMiressa JibaloOwner · (507) 329-5751
Enumeration DateFebruary 28, 2024
Last NPPES UpdateApril 7, 2024
NPPES CertifiedApril 7, 2024
✔ NPI 1063279834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedAssisted Living Facility · Assisted Living, Mental IllnessTaxonomy 3104A0625X
Also ListedAssisted Living Facility · Assisted Living, Behavioral DisturbancesTaxonomy 3104A0630X
15300 DUNDEE CT, Apple Valley, MN 55124
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Other Names 1

Doing Business AsNew Life Home

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 24D2269366

New Life Home LLC · Apple Valley, MN
Active · expires Sep 25, 2026
CLIA Number24D2269366
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 26, 2024
Certificate Expiration DateSeptember 25, 2026
Laboratory DirectorLeslie Huna
Laboratory Phone(507) 329-5751
Laboratory LocationNew Life Home LLC15300 Dundee Ct, Apple Valley, MN 55124
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 New Life Home LLC's NPI number?

The NPI number for New Life Home LLC is 1063279834. It was assigned to this organization in the NPPES registry on February 28, 2024. The provider is doing business as New Life Home.

Where is New Life Home LLC located?

New Life Home LLC is located at 15300 Dundee Ct, Apple Valley, MN 55124. The listed phone number is (612) 441-2030.

What is New Life Home LLC's specialty?

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

Does New Life Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2269366) is associated with this NPI, valid through September 25, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for New Life Home LLC was last updated on April 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.