Healthcare Provider Details

I. General information

NPI: 1437631447
Provider Name (Legal Business Name): HARMONY ADULT DAY CARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8503 JEFFERSON LN N STE B
BROOKLYN PARK MN
55445-2115
US

IV. Provider business mailing address

8503 JEFFERSON LN N STE B
BROOKLYN PARK MN
55445-2115
US

V. Phone/Fax

Practice location:
  • Phone: 763-898-3525
  • Fax:
Mailing address:
  • Phone: 763-898-3525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1092924
License Number StateMN

VIII. Authorized Official

Name: ALI ADAM HASSAN
Title or Position: DIRECTOR
Credential: DIRECTOR
Phone: 612-707-5737