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General NPI Number Information
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NPI Number | 1811378771
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Entity Type | Organization
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Legal Business Name | AFRICAN COMMUNITY CENTER OF SIOUX FALLS
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 1515 EAST 10TH STREET
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City | SIOUX FALLS
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State | SD
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Zip | 57103
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Country | US
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Telephone | 605-215-4959
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 E 10TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57103-1721
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Country | US
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Telephone | 605-215-4959
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HIRSI ABDULKADIR MOHAMED
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Credential |
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Telephone | 605-215-4959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | NS015147
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License Number State | SD
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