| NPI | 1760289292 | 
|---|---|
| Doing Business As | LLC | 
| Entity Type | Organization | 
| Authorized Contact | BAHJO H MAHAMUD Owner 612-703-7465 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care | 
| Enumeration Date | 2025-03-03 | 
| Last Update Date | 2025-03-04 |