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PLATEAU HEALTHCARE MAPLE GROVE LLC
NPI 1811544166
Nursing Care in Maple Grove, MN

Active since August 21, 2019
9962 104TH AVE N, MAPLE GROVE, MN 55369(763) 444-1361(763) 444-1358 Get Directions Write a Review

NPPES record last updated: August 21, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Plateau Healthcare Maple Grove Llc NPPES

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

PLATEAU HEALTHCARE MAPLE GROVE LLC (NPI 1811544166), doing business as Phc Maple Grove, is a healthcare organization registered as a nursing care in Maple Grove, Minnesota and active in the NPI registry since August 2019. The organization lists Faisale Boukari, President, as its authorized official.

NPPES Registry Identity

NPI1811544166
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NamePLATEAU HEALTHCARE MAPLE GROVE LLC
Location Address9962 104TH AVE NMaple Grove, MN 55369-2941
Mailing Address8848 Zealand Ave N Ste BBrooklyn Park, MN 55445-1891 · (763) 444-1361 · Fax (763) 444-1358
Phone(763) 444-1361
Fax(763) 444-1358
Organization SubpartNo
Authorized OfficialFaisale BoukariPresident · (763) 444-1361
Enumeration DateAugust 21, 2019
✔ NPI 1811544166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
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 ListedHome HealthTaxonomy 251E00000X
Also ListedIn Home Supportive CareTaxonomy 253Z00000X
9962 104TH AVE N, Maple Grove, MN 55369
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Other Names 1

Doing Business AsPhc Maple Grove

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 Plateau Healthcare Maple Grove LLC's NPI number?

The NPI number for Plateau Healthcare Maple Grove LLC is 1811544166. It was assigned to this organization in the NPPES registry on August 21, 2019. The provider is doing business as PHC Maple Grove.

Where is Plateau Healthcare Maple Grove LLC located?

Plateau Healthcare Maple Grove LLC is located at 9962 104th Ave N, Maple Grove, MN 55369. The listed phone number is (763) 444-1361.

What is Plateau Healthcare Maple Grove LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Plateau Healthcare Maple Grove LLC was last updated on August 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.