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DOMINION HEALTHCARE SERVICES LLC
NPI 1639710460
Home Health in Brooklyn Center, MN

Active since October 02, 2019CLIA 24D2174223 · Waiver
6918 GRIMES AVE N, BROOKLYN CENTER, MN 55429(612) 258-8794 Get Directions Write a Review

NPPES record last updated: June 24, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dominion Healthcare Services Llc NPPES

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

DOMINION HEALTHCARE SERVICES LLC (NPI 1639710460) is a healthcare organization registered as a home health in Brooklyn Center, Minnesota and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through October 28, 2027 and lists Yaria Isabella Bangura, Administrator, as its authorized official.

NPPES Registry Identity

NPI1639710460
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameDOMINION HEALTHCARE SERVICES LLC
Location Address6918 GRIMES AVE NBrooklyn Center, MN 55429-1450
Mailing Address6918 Grimes Ave NBrooklyn Center, MN 55429-1450 · (612) 258-8794
Phone(612) 258-8794
Organization SubpartNo
Authorized OfficialYaria Isabella BanguraAdministrator · (612) 812-4744
Enumeration DateOctober 2, 2019
Last NPPES UpdateJune 24, 2022
NPPES CertifiedJune 24, 2022
✔ NPI 1639710460 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.
6918 GRIMES AVE N, Brooklyn Center, MN 55429
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Other Names 1

Doing Business AsDominion Healthcare Services Llc

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 24D2174223

Dominion Healthcare Services LLC · Brooklyn Center, MN
Active · expires Oct 28, 2027
CLIA Number24D2174223
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 29, 2025
Certificate Expiration DateOctober 28, 2027
Laboratory DirectorYaria I. Bangura
Laboratory Phone(612) 812-4744
Laboratory LocationDominion Healthcare Services LLC5421 Penn Ave N, Brooklyn Center, MN 55430
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 Dominion Healthcare Services LLC's NPI number?

The NPI number for Dominion Healthcare Services LLC is 1639710460. It was assigned to this organization in the NPPES registry on October 2, 2019.

Where is Dominion Healthcare Services LLC located?

Dominion Healthcare Services LLC is located at 6918 Grimes Ave N, Brooklyn Center, MN 55429. The listed phone number is (612) 258-8794.

What is Dominion Healthcare Services LLC's specialty?

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

Does Dominion Healthcare Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2174223) is associated with this NPI, valid through October 28, 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 Dominion Healthcare Services LLC was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.