Provider Demographics
NPI:1982442539
Name:MAGNANIMOUS LLC
Entity type:Organization
Organization Name:MAGNANIMOUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SAADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN LALD
Authorized Official - Phone:612-532-6966
Mailing Address - Street 1:3108 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-5235
Mailing Address - Country:US
Mailing Address - Phone:612-532-6966
Mailing Address - Fax:
Practice Address - Street 1:920 MILDRED DR
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-1370
Practice Address - Country:US
Practice Address - Phone:612-216-8980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAGNANIMOUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility