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

NPI Status: Active since October 02, 2019

Contact Information

6918 GRIMES AVE N
BROOKLYN CENTER, MN
ZIP 55429
Phone: (612) 258-8794

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  • Organization
  • Home Health
  • CLIA Number: 24D2174223
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 10-28-2027

About DOMINION HEALTHCARE SERVICES LLC

This page provides the complete NPI Profile along with additional information for Dominion Healthcare Services Llc, a provider established in Brooklyn Center, Minnesota operating as a Home Health. The healthcare provider is registered in the NPI registry with number 1639710460 assigned on October 2019. The practitioner's primary taxonomy code is 251E00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Dominion Healthcare Services Llc. The authorized official of this NPI record is Yaria Isabella Bangura (Administrator)

NPI
1639710460
Provider Legal Name
DOMINION HEALTHCARE SERVICES LLC
Other Organization Name
DOMINION HEALTHCARE SERVICES LLC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
6918 GRIMES AVE N BROOKLYN CENTER, MN 55429
Location Phone
(612) 258-8794
Mailing Address
6918 GRIMES AVE N BROOKLYN CENTER, MN 55429
Mailing Phone
(612) 258-8794
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-02-2019
Last Update Date
06-24-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Home Health

Taxonomy Code
251E00000X
Type
Agencies
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

YARIA ISABELLA BANGURA

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(612) 812-4744

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2174223
Facility Type
Assisted Living Facility
Certificate Effective Date
October 29, 2025
Certificate Expiration Date
October 28, 2027
Laboratory Director
YARIA I. BANGURA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Dominion Healthcare Services Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1639710460, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
3
Doubled → 6
Pos 4
9
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 7 → 14 → 5 0 → 0 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 6 + 9 + 1 + 4 + 1 + 0 + 4 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1639710460.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639710460, enumerated as an "organization" on October 02, 2019.

The provider is located at 6918 GRIMES AVE N BROOKLYN CENTER, MN 55429 and the phone number is (612) 258-8794.

Home Health with taxonomy code 251E00000X.