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BETHEL PAVILION HOMECARE LLC
NPI 1932688223
Assisted Living Facility in Brooklyn Park, MN

Active since August 08, 2018CLIA Certified · 2 labs
3816 83RD AVE N, BROOKLYN PARK, MN 55443(763) 227-7572 Get Directions Write a Review

NPPES record last updated: September 12, 2018. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 12, 2018, Aug 8, 2018 (2 updates tracked since 2018).

About Bethel Pavilion Homecare Llc NPPES

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

BETHEL PAVILION HOMECARE LLC (NPI 1932688223) is a healthcare organization registered as an assisted living facility in Brooklyn Park, Minnesota and active in the NPI registry since August 2018. The organization holds 2 active CLIA laboratory certificates and lists Rosebella Nyaboke Ogoro, Administrator, as its authorized official.

NPPES Registry Identity

NPI1932688223
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBETHEL PAVILION HOMECARE LLC
Location Address3816 83RD AVE NBrooklyn Park, MN 55443-2753
Mailing Address7535 Douglas Dr NBrooklyn Park, MN 55443-2931
Phone(763) 227-7572
Organization SubpartNo
Authorized OfficialRosebella Nyaboke OgoroAdministrator · (763) 227-7572
Enumeration DateAugust 8, 2018
Last NPPES UpdateSeptember 12, 20182 updates tracked since enumeration
✔ NPI 1932688223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
3816 83RD AVE N, Brooklyn Park, MN 55443
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CLIA Laboratory Certificates CMS CLIA 2

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 24D2232997

Bethel Pavilion Homecare LLC · Brooklyn Park, MN
Active · expires Aug 18, 2027
CLIA Number24D2232997
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 19, 2025
Certificate Expiration DateAugust 18, 2027
Laboratory DirectorLydia I. Oyewole
Laboratory Phone(763) 501-3737
Laboratory LocationBethel Pavilion Homecare LLC7535 Douglas Drive North, Brooklyn Park, MN 55443
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2166869

Bethel Pavilion Homecare Lcc · Brooklyn Park, MN
Active · expires May 27, 2027
CLIA Number24D2166869
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 28, 2025
Certificate Expiration DateMay 27, 2027
Laboratory DirectorRosebella N. Ogoro
Laboratory Phone(763) 913-7094
Laboratory LocationBethel Pavilion Homecare Lcc3816 83rd Ave N, Brooklyn Park, MN 55443
CLIA data matches this NPI record on: Address Name
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 Bethel Pavilion Homecare LLC's NPI number?

The NPI number for Bethel Pavilion Homecare LLC is 1932688223. It was assigned to this organization in the NPPES registry on August 8, 2018.

Where is Bethel Pavilion Homecare LLC located?

Bethel Pavilion Homecare LLC is located at 3816 83rd Ave N, Brooklyn Park, MN 55443. The listed phone number is (763) 227-7572.

What is Bethel Pavilion Homecare LLC's specialty?

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

Does Bethel Pavilion Homecare LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Bethel Pavilion Homecare LLC was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.