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General NPI Number Information
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NPI Number | 1609643410
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Entity Type | Organization
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Legal Business Name | RECUPERATIVE HOMES
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Dates
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Enumeration Date | 12/11/2023
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 8232 BRANDYWINE PKWY
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City | BROOKLYN PARK
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State | MN
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Zip | 55444-1508
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Country | US
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Telephone | 507-213-1673
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Fax |
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Provider Business Mailing Address
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Address Line | 8609 LYNDALE AVE S STE 218
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City | BLOOMINGTON
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State | MN
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Zip | 55420-2717
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Country | US
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Telephone | 507-213-1673
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MOHAMED ABDI MOHAMED
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Credential |
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Telephone | 507-213-1673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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