Healthcare Provider Details

I. General information

NPI: 1467717413
Provider Name (Legal Business Name): MULTICULTURAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 CENTRAL AVE NE
MINNEAPOLIS MN
55418-3710
US

IV. Provider business mailing address

2330 CENTRAL AVE NE
MINNEAPOLIS MN
55418-3710
US

V. Phone/Fax

Practice location:
  • Phone: 612-781-1212
  • Fax: 612-781-5251
Mailing address:
  • Phone: 612-781-1212
  • Fax: 612-781-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUAD HAJI
Title or Position: CLINIC MANAGER
Credential:
Phone: 612-987-1439