Healthcare Provider Details

I. General information

NPI: 1174452056
Provider Name (Legal Business Name): HIGHGROUND HOUSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 15TH ST STE 415C
SAN DIEGO CA
92101-8098
US

IV. Provider business mailing address

845 15TH ST STE 415C
SAN DIEGO CA
92101-8098
US

V. Phone/Fax

Practice location:
  • Phone: 612-404-8354
  • Fax:
Mailing address:
  • Phone: 612-404-8354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: YASSIR ABDI
Title or Position: OWNER
Credential:
Phone: 612-404-8354