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General NPI Number Information
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NPI Number | 1821948852
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Entity Type | Organization
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Legal Business Name | SUMMERROSE CARE LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1821 UNIVERSITY AVE W STE 464-4
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City | SAINT PAUL
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State | MN
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Zip | 55104-2801
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Country | US
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Telephone | 619-830-1146
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 UNIVERSITY AVE W STE 464-4
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City | SAINT PAUL
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State | MN
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Zip | 55104-2801
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Country | US
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Telephone | 619-830-1146
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FADUMO MOHAMED MAHAMED
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Credential |
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Telephone | 619-830-1146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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