Healthcare Provider Details

I. General information

NPI: 1598225328
Provider Name (Legal Business Name): ACTION FOR EAST AFRICAN PEOPLE AFEAP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 W OLD SHAKOPEE RD
BLOOMINGTON MN
55431-3555
US

IV. Provider business mailing address

3701 W OLD SHAKOPEE RD
BLOOMINGTON MN
55431-3555
US

V. Phone/Fax

Practice location:
  • Phone: 612-458-2824
  • Fax:
Mailing address:
  • Phone: 612-458-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AYAN ABUKAR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-458-6830