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FAIRHAVENS HOME CARE
NPI 1417342494
Nursing Care in Brooklyn Park, MN

Active since April 06, 2015CLIA 24D2274747 · Waiver
2608 87TH TRL N, BROOKLYN PARK, MN 55443(763) 222-4746(763) 888-0075 Get Directions Write a Review

NPPES record last updated: April 6, 2015. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Fairhavens Home Care NPPES

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

FAIRHAVENS HOME CARE (NPI 1417342494) is a healthcare organization registered as a nursing care in Brooklyn Park, Minnesota and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through January 9, 2027 and lists Emeka Linus Chikwelu Okafor, President, as its authorized official.

NPPES Registry Identity

NPI1417342494
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NameFAIRHAVENS HOME CARE
Location Address2608 87TH TRL NBrooklyn Park, MN 55443-3742
Mailing Address2608 87th Trl NBrooklyn Park, MN 55443-3742 · (763) 222-4746 · Fax (763) 888-0075
Phone(763) 222-4746
Fax(763) 888-0075
Organization SubpartNo
Authorized OfficialEmeka Linus Chikwelu OkaforPresident · (763) 222-4746
Enumeration DateApril 6, 2015
✔ NPI 1417342494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
License✔ Licensed in MN · 1077353-1-HCBS
Definition
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.
Also ListedIn Home Supportive CareTaxonomy 253Z00000X · License 1077353-1-HCBS (MN)
2608 87TH TRL N, Brooklyn Park, MN 55443
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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 24D2274747

Fairhavens Home Care LLC · Brooklyn Park, MN
Active · expires Jan 9, 2027
CLIA Number24D2274747
Laboratory TypeHome Health Agency
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorEmeka Okafor
Laboratory Phone(763) 222-4746
Laboratory LocationFairhavens Home Care LLC2608 87th Trail N, Brooklyn Park, MN 55443
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

FAIRHAVENS HOME CARE
Skilled Nursing Facility (Nursing Care, Pediatric)
2608 87TH TRL N
BROOKLYN PARK, MN 55443
Hennepin County (763) 222-4747
FAIRHAVENS HOME CARE LLC
Home Health
2608 87TH TRL N
BROOKLYN PARK, MN 55443
Hennepin County (763) 222-4746

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 Fairhavens Home Care's NPI number?

The NPI number for Fairhavens Home Care is 1417342494. It was assigned to this organization in the NPPES registry on April 6, 2015.

Where is Fairhavens Home Care located?

Fairhavens Home Care is located at 2608 87th Trl N, Brooklyn Park, MN 55443. The listed phone number is (763) 222-4746.

What is Fairhavens Home Care's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

Does Fairhavens Home Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2274747) is associated with this NPI, valid through January 9, 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 Fairhavens Home Care was last updated on April 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.