| NPI | 1669819280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYSAL ABDIAZIZ AHMED President 763-913-8054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2013-05-31 |