Healthcare Provider Details

I. General information

NPI: 1972285385
Provider Name (Legal Business Name): KIDSCARE SOLUTION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 30TH AVE S STE 107A
MOORHEAD MN
56560-5000
US

IV. Provider business mailing address

819 30TH AVE S STE 107A
MOORHEAD MN
56560-5000
US

V. Phone/Fax

Practice location:
  • Phone: 701-729-1001
  • Fax:
Mailing address:
  • Phone: 701-729-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ZAKARIA ABDULLAHI
Title or Position: PRESIDENT
Credential:
Phone: 701-729-1001