PRIME ENTERPRISE INC. NPI 1508947169

NPI Information

  • NPI: 1508947169
  • Provider Name: PRIME ENTERPRISE, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: PRIME ENTERPRISE, INC.
  • Address: 505 JANESVILLE ST NE
    FRIDLEY, MN
    ZIP 55432
  • Phone: (952) 451-4941

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NPI Details

PRIME ENTERPRISE, INC. is an assisted living facility in Fridley, MN. The provider is 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. PRIME ENTERPRISE, INC. NPI is 1508947169. The provider is registered as an organization entity type.
The provider Is Doing Business As Prime Enterprise, Inc..

The provider's business location address is:

505 JANESVILLE ST NE
FRIDLEY, MN
ZIP 55432-638
Phone: (952) 451-4941

The provider's authorized official is Osetohame Agene .
The authorized official title is President/owner and has the following contact phone number (952) 451-4941.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility333542MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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