| NPI | 1770115479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISMAIL J MOHAMED CEO/Durector 952-217-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 225100000X Physical Therapist |
| 227800000X Respiratory Therapist, Certified | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |