| NPI | 1841696531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIRIZAK ALI Owner 612-298-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2014-11-07 |