Healthcare Provider Details

I. General information

NPI: 1497032320
Provider Name (Legal Business Name): MULTI COMMUNITY ADULT DAY CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2011
Last Update Date: 06/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CENTRAL AVE NE
MINNEAPOLIS MN
55418-4551
US

IV. Provider business mailing address

1900 CENTRAL AVE NE
MINNEAPOLIS MN
55418-4551
US

V. Phone/Fax

Practice location:
  • Phone: 612-242-1316
  • Fax:
Mailing address:
  • Phone: 612-242-1316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FADUMA A HASHI
Title or Position: DIRECTOR
Credential:
Phone: 612-242-1316