MEDICARE: CENTER FOR SOMALI SOLUTIONS & UNITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	BAU0007173	MN

General Provider Information

NPI Number	:	1316244163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR SOMALI SOLUTIONS & UNITY

Provider Business Mailing Address
First Line	:	2121 NICOLLET AVE
Second Line	:	SUITE 4
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2566
Country	:	US
Telephone Number	:	612-287-5158
Fax Number	:	612-871-6411

Provider Business Practice Location Address
First Line	:	2121 NICOLLET AVE
Second Line	:	SUITE 4
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2566
Country	:	US
Telephone Number	:	612-287-5158
Fax Number	:	612-871-6411

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MAHDI ALI HAILE
Credential	:	MR.
Telephone Number	:	612-987-9284

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	02/14/2011

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