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General NPI Number Information
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NPI Number | 1497318828
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Entity Type | Organization
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Legal Business Name | HOUSING WITH CARE
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 3001 METRO DR STE 210
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1696
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Country | US
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Telephone | 952-500-8634
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Fax | 952-479-3419
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Provider Business Mailing Address
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Address Line | 8200 HUMBOLDT AVE S STE 218
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1432
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Country | US
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Telephone | 952-457-5734
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | HUSSEIN HASSAN MOHAMED
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Credential |
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Telephone | 952-457-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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