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RESIDENTIAL CARE AT NINE MILE CREEK
NPI 1154794089
Assisted Living Facility in Bloomington, MN

Active since October 30, 2015CLIA Certified · 3 labs
10641 JAMES RD, BLOOMINGTON, MN 55431(952) 229-4213 Get Directions Write a Review

NPPES record last updated: October 30, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Residential Care At Nine Mile Creek NPPES

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

RESIDENTIAL CARE AT NINE MILE CREEK (NPI 1154794089) is a healthcare organization registered as an assisted living facility in Bloomington, Minnesota and active in the NPI registry since October 2015. The organization holds 3 active CLIA laboratory certificates and lists Sadik Ali Abdi, Owner, as its authorized official.

NPPES Registry Identity

NPI1154794089
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameRESIDENTIAL CARE AT NINE MILE CREEK
Location Address10641 JAMES RDBloomington, MN 55431-4130
Mailing Address10641 James RdBloomington, MN 55431-4130 · (952) 229-4213
Phone(952) 229-4213
Organization SubpartNo
Authorized OfficialSadik Ali AbdiOwner · (612) 978-2238
Enumeration DateOctober 30, 2015
✔ NPI 1154794089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 374950
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.
10641 JAMES RD, Bloomington, MN 55431
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CLIA Laboratory Certificates CMS CLIA 3

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 24D2115966

Residential Care At Nine Mile Creek · Bloomington, MN
Active · expires Jul 14, 2028
CLIA Number24D2115966
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorAbdiraham Jama
Laboratory Phone(952) 229-4213
Laboratory LocationResidential Care At Nine Mile Creek10641 James Road, Bloomington, MN 55431
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2148162

Residential Care At Nine Mile Creek · Richfield, MN
Active · expires May 3, 2028
CLIA Number24D2148162
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 4, 2026
Certificate Expiration DateMay 3, 2028
Laboratory DirectorAbdifatah Mohamed
Laboratory Phone(612) 978-2238
Laboratory LocationResidential Care At Nine Mile Creek6520 Portland Avenue South, Richfield, MN 55423
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2215216

Residential Care At Nine Mile Creek · Richfield, MN
Active · expires Mar 1, 2027
CLIA Number24D2215216
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 2, 2025
Certificate Expiration DateMarch 1, 2027
Laboratory DirectorMohamud A. Abdirahman
Laboratory Phone(612) 978-2238
Laboratory LocationResidential Care At Nine Mile Creek7421 13th Ave S, Richfield, MN 55423
CLIA data matches this NPI record on: 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 Residential Care At Nine Mile Creek's NPI number?

The NPI number for Residential Care At Nine Mile Creek is 1154794089. It was assigned to this organization in the NPPES registry on October 30, 2015.

Where is Residential Care At Nine Mile Creek located?

Residential Care At Nine Mile Creek is located at 10641 James Rd, Bloomington, MN 55431. The listed phone number is (952) 229-4213.

What is Residential Care At Nine Mile Creek's specialty?

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

Does Residential Care At Nine Mile Creek hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Residential Care At Nine Mile Creek was last updated on October 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.