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NPI 1265290126

NPI 1265290126 : FOUNDATION OF HOPE INC : ROSEVILLE, MN

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General NPI Number Information
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    NPI Number           |    1265290126
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    Entity Type          |    Organization 
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    Legal Business Name  |    FOUNDATION OF HOPE INC 
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Dates
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    Enumeration Date     |    03/06/2024
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    Last Update Date     |    03/06/2024
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Provider Practice Location Address
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    Address Line         |    1214 AUTUMN ST 
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    City                 |    ROSEVILLE
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    State                |    MN
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    Zip                  |    55113-6101
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    Country              |    US
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    Telephone            |    763-331-2274
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1214 AUTUMN ST 
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    City                 |    ROSEVILLE
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    State                |    MN
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    Zip                  |    55113-6101
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    Country              |    US
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    Telephone            |    763-331-2274
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JIMALE ABDI MOHAMED 
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    Credential           |    
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    Telephone            |    763-331-2274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    323P00000X
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    Taxonomy Name        |    Psychiatric Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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