Healthcare Provider Details

I. General information

NPI: 1972485571
Provider Name (Legal Business Name): CRESCENT CARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 EMERSON AVE S STE 302
MINNEAPOLIS MN
55405-6100
US

IV. Provider business mailing address

2415 EMERSON AVE S STE 302
MINNEAPOLIS MN
55405-6100
US

V. Phone/Fax

Practice location:
  • Phone: 612-476-9933
  • Fax:
Mailing address:
  • Phone: 612-476-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIBAN JAMA
Title or Position: OWNER
Credential:
Phone: 612-476-9933