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General NPI Number Information
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NPI Number | 1851115943
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Entity Type | Organization
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Legal Business Name | MULK CARE, LLC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 3800 72ND AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-1418
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Country | US
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Telephone | 612-323-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 72ND AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55429-1418
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Country | US
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Telephone | 612-323-1196
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MOHAMED ALI MOHAMED
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Credential |
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Telephone | 612-323-1196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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