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Organization
SECOND STORY LLC
Active
Organization
SECOND STORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKHTAR DAHIR (OWNER)
(763) 346-0311
Entity
Organization
Contact information
Practice address
1013 W RIVER RD, CHAMPLIN, MN 55316-2002
(763) 346-0311
Mailing address
5273 OAK GROVE PKWY N, BROOKLYN PARK, MN 55443-4401
(763) 346-0311
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
425562
MN DEPT OF HEALTH ASSISTED LIVING FACILITY LICENSE
MN
Enumeration date
04/09/2026
Last updated
07/30/2026
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