Healthcare Provider Details

I. General information

NPI: 1306663547
Provider Name (Legal Business Name): KOWSAR HOUSING SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 BLOOMINGTON AVE
BLOOMINGTON MN
55425-1108
US

IV. Provider business mailing address

8116 BLOOMINGTON AVE
BLOOMINGTON MN
55425-1108
US

V. Phone/Fax

Practice location:
  • Phone: 716-416-8989
  • Fax:
Mailing address:
  • Phone: 716-416-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIFATAH ABDULLAHI
Title or Position: OWNER
Credential:
Phone: 716-416-8989