Healthcare Provider Details

I. General information

NPI: 1053154310
Provider Name (Legal Business Name): DAAUZCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 06/14/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15151 GREENHAVEN DR APT 105
BURNSVILLE MN
55306-6151
US

IV. Provider business mailing address

15151 GREENHAVEN DR APT 105
BURNSVILLE MN
55306-6151
US

V. Phone/Fax

Practice location:
  • Phone: 612-817-9160
  • Fax:
Mailing address:
  • Phone: 612-817-9160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FARDOWSA MOHAMUD ADAN
Title or Position: OWNER AND MANAGER
Credential:
Phone: 612-817-9160