Healthcare Provider Details

I. General information

NPI: 1639946981
Provider Name (Legal Business Name): FIKOONI HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 12/07/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 28TH AVE N STE A-106
SAINT CLOUD MN
56303-4640
US

IV. Provider business mailing address

37 28TH AVE N STE A-106
SAINT CLOUD MN
56303-4640
US

V. Phone/Fax

Practice location:
  • Phone: 320-267-9750
  • Fax:
Mailing address:
  • Phone: 320-267-9750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ISMAIL ABDI MUSE
Title or Position: OWNER AND CEO
Credential:
Phone: 620-267-9750