Healthcare Provider Details

I. General information

NPI: 1316136203
Provider Name (Legal Business Name): SOMALI FAMILY AND YOUTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 38TH ST SUITE G.
MINNEAPOLIS MN
55409-1300
US

IV. Provider business mailing address

310 E 38TH ST SUITE G.
MINNEAPOLIS MN
55409-1300
US

V. Phone/Fax

Practice location:
  • Phone: 612-252-2416
  • Fax: 612-252-2412
Mailing address:
  • Phone: 612-252-2416
  • Fax: 612-252-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateMN

VIII. Authorized Official

Name: SAEED H JAMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-227-9249