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General NPI Number Information
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NPI Number | 1528780061
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Entity Type | Organization
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Legal Business Name | SEED SENIOR LIVING
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 5422 W OLD SHAKOPEE CIR
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City | BLOOMINGTON
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State | MN
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Zip | 55437-2766
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Country | US
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Telephone | 952-395-2470
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Fax | 952-443-8604
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Provider Business Mailing Address
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Address Line | 5422 W OLD SHAKOPEE CIR
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City | BLOOMINGTON
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State | MN
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Zip | 55437-2766
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Country | US
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Telephone | 952-395-2470
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Fax | 952-443-8604
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Authorized Official
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Title or Position | HOUSE MANAGER
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Name | FARTUN AHMED ROBLE
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Credential |
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Telephone | 952-395-2470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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