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EAGLE GROUP HOME
NPI 1326681511
Home Health in Minneapolis, MN

Active since October 21, 2019CLIA 24D2175631 · Waiver
2104 PARK AVE, MINNEAPOLIS, MN 55404(612) 644-6127 Get Directions Write a Review

NPPES record last updated: October 21, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Eagle Group Home NPPES

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

EAGLE GROUP HOME (NPI 1326681511) is a healthcare organization registered as a home health in Minneapolis, Minnesota and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through November 24, 2027 and lists Khadija Abdikarim, President, as its authorized official.

NPPES Registry Identity

NPI1326681511
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameEAGLE GROUP HOME
Location Address2104 PARK AVEMinneapolis, MN 55404-6607
Mailing Address2104 Park AveMinneapolis, MN 55404-6607 · (612) 644-6127
Phone(612) 644-6127
Organization SubpartNo
Authorized OfficialKhadija AbdikarimPresident · (612) 644-6127
Enumeration DateOctober 21, 2019
✔ NPI 1326681511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
2104 PARK AVE, Minneapolis, MN 55404
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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 24D2175631

Eagle Group Home LLC · Minneapolis, MN
Active · expires Nov 24, 2027
CLIA Number24D2175631
Laboratory TypeHome Health Agency
Certificate Effective DateNovember 25, 2025
Certificate Expiration DateNovember 24, 2027
Laboratory DirectorKhadija K. Abdikarim
Laboratory Phone(612) 354-3024
Laboratory LocationEagle Group Home LLC2653 14th Avenue S, Minneapolis, MN 55407
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMPOWER WELLNESS PSYCHIATRIC & MANAGEMENT P. L. L. C.
Psychiatry & Neurology (Psychiatry)
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (763) 732-2080
MS. MICHELLE AUSTIN LICSW
Social Worker (Clinical)
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (952) 649-0512
FIRST CHOICE HOME CARE INC
Home Health
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 353-4509
OKACH KWOT
Counselor
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 295-2979
REGIONS WAIVER SERVICES L.L.C.
Clinic/Center
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (651) 324-3748
LIFETRACK WELLNESS INC
Early Intervention Provider Agency
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (952) 649-0512
BRAVO HEALTH SERVICE, INC
Clinic/Center (Mental Health (Including Community Mental Health Center))
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (612) 295-2979
PRIOMH HEALING SERVICES INC
Clinic/Center (Adult Mental Health)
2104 PARK AVE
MINNEAPOLIS, MN 55404
Hennepin County (952) 649-0512

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 Eagle Group Home's NPI number?

The NPI number for Eagle Group Home is 1326681511. It was assigned to this organization in the NPPES registry on October 21, 2019.

Where is Eagle Group Home located?

Eagle Group Home is located at 2104 Park Ave, Minneapolis, MN 55404. The listed phone number is (612) 644-6127.

What is Eagle Group Home's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Eagle Group Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2175631) 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 Eagle Group Home was last updated on October 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.