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ANTIQUE GARDENS SENIOR CARE LLC
NPI 1093672180
Assisted Living Facility in Brooklyn Park, MN

Active since January 08, 2026CLIA 24D2331747 · Waiver
6617 76TH AVE N, BROOKLYN PARK, MN 55428(763) 260-7298(612) 484-4413 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Antique Gardens Senior Care Llc NPPES

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

ANTIQUE GARDENS SENIOR CARE LLC (NPI 1093672180) is a healthcare organization registered as an assisted living facility in Brooklyn Park, Minnesota and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through October 7, 2027 and lists Jawahir Ahmed, Ceo, as its authorized official.

NPPES Registry Identity

NPI1093672180
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameANTIQUE GARDENS SENIOR CARE LLC
Location Address6617 76TH AVE NBrooklyn Park, MN 55428-1435
Mailing Address6617 76th Ave NBrooklyn Park, MN 55428-1435 · (763) 260-7298 · Fax (612) 484-4413
Phone(763) 260-7298
Fax(612) 484-4413
Organization SubpartNo
Authorized OfficialJawahir AhmedCeo · (763) 260-7298
Enumeration DateJanuary 8, 2026
NPPES CertifiedJanuary 8, 2026
✔ NPI 1093672180 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.
6617 76TH AVE N, Brooklyn Park, MN 55428
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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 24D2331747

Antique Gardens Senior Care LLC · Brooklyn Park, MN
Active · expires Oct 7, 2027
CLIA Number24D2331747
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 8, 2025
Certificate Expiration DateOctober 7, 2027
Laboratory DirectorAbdifatah A. Keynan
Laboratory Phone(763) 260-7298
Laboratory LocationAntique Gardens Senior Care LLC6617 76th Ave North, Brooklyn Park, MN 55428
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 Antique Gardens Senior Care LLC's NPI number?

The NPI number for Antique Gardens Senior Care LLC is 1093672180. It was assigned to this organization in the NPPES registry on January 8, 2026.

Where is Antique Gardens Senior Care LLC located?

Antique Gardens Senior Care LLC is located at 6617 76th Ave N, Brooklyn Park, MN 55428. The listed phone number is (763) 260-7298.

What is Antique Gardens Senior Care LLC's specialty?

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

Does Antique Gardens Senior Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2331747) is associated with this NPI, valid through October 7, 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 Antique Gardens Senior Care LLC was last updated on January 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.