Healthcare Provider Details

I. General information

NPI: 1144689464
Provider Name (Legal Business Name): TARGET INTERPRETATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 3RD ST S APT 307B
WAITE PARK MN
56387-1376
US

IV. Provider business mailing address

248 3RD ST S APT 307B
WAITE PARK MN
56387-1376
US

V. Phone/Fax

Practice location:
  • Phone: 651-210-9428
  • Fax:
Mailing address:
  • Phone: 651-210-9428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberJ130181190804
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberJ130181190804
License Number StateMN

VIII. Authorized Official

Name: MOHAMED NUR
Title or Position: PRESIDENT
Credential:
Phone: 651-210-9428