MEDICARE: CHERISH HOUSE

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1730848995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERISH HOUSE

Provider Business Mailing Address
First Line	:	315 COOK AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55130-3823
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 COOK AVE E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55130-3823
Country	:	US
Telephone Number	:	507-358-5276
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. AHMEDNUR ALI
Credential	:	PHARMD
Telephone Number	:	507-358-5276

Provider Enumeration Date	:	12/14/2021
Last Update Date	:	12/14/2021

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Directions to “CHERISH HOUSE ” Practice Location

Language	Start Address	Practice Location

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