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HAWTHORNE HOUSE INC
NPI 1891976841
Assisted Living Facility in Golden Valley, MN

Active since November 19, 2007CLIA 24D1084162 · Waiver
6931 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427(612) 385-9200(763) 205-1950 Get Directions Write a Review

NPPES record last updated: November 19, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hawthorne House Inc NPPES

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

HAWTHORNE HOUSE INC (NPI 1891976841) is a healthcare organization registered as an assisted living facility in Golden Valley, Minnesota and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through May 15, 2028 and lists Susanthi Renuka Fernando, Business Consultant, as its authorized official.

NPPES Registry Identity

NPI1891976841
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHAWTHORNE HOUSE INC
Location Address6931 COUNTRY CLUB DRGolden Valley, MN 55427-4604
Mailing AddressPo Box 27482Golden Valley, MN 55427-0482 · (612) 385-9200 · Fax (763) 205-1950
Phone(612) 385-9200
Fax(763) 205-1950
Organization SubpartNo
Authorized OfficialSusanthi Renuka FernandoBusiness Consultant · (612) 385-9200
Enumeration DateNovember 19, 2007
✔ NPI 1891976841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 23104
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
6931 COUNTRY CLUB DR, Golden Valley, MN 55427
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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 24D1084162

Hawthorne House Inc · Golden Valley, MN
Active · expires May 15, 2028
CLIA Number24D1084162
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 16, 2026
Certificate Expiration DateMay 15, 2028
Laboratory DirectorSusanthi R. Fernando
Laboratory Phone(612) 385-9200
Laboratory LocationHawthorne House Inc6931 Country Club Drive, Golden Valley, MN 55427
CLIA data matches this NPI record on: Address 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 Hawthorne House Inc's NPI number?

The NPI number for Hawthorne House Inc is 1891976841. It was assigned to this organization in the NPPES registry on November 19, 2007.

Where is Hawthorne House Inc located?

Hawthorne House Inc is located at 6931 Country Club Dr, Golden Valley, MN 55427. The listed phone number is (612) 385-9200.

What is Hawthorne House Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Hawthorne House Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1084162) is associated with this NPI, valid through May 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hawthorne House Inc was last updated on November 19, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.