Healthcare Provider Details

I. General information

NPI: 1215733274
Provider Name (Legal Business Name): SWIFT AND DEDICATED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15897 NORWAY ST NW
ANDOVER MN
55304-4353
US

IV. Provider business mailing address

15897 NORWAY ST NW
ANDOVER MN
55304-4353
US

V. Phone/Fax

Practice location:
  • Phone: 612-532-5138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RIAD ABDULLAHI
Title or Position: OWNER
Credential:
Phone: 612-532-5138