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General NPI Number Information
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NPI Number | 1962067090
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Entity Type | Organization
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Legal Business Name | MORNINGSTAR CARE SERVICES,LLC.
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 11347 ELDORADO ST NE UNIT D
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City | BLAINE
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State | MN
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Zip | 55449-4552
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Country | US
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Telephone | 602-679-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 11347 ELDORADO ST NE UNIT D
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City | BLAINE
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State | MN
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Zip | 55449-4552
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Country | US
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Telephone | 602-679-0020
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BASHEIR W ELMI
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Credential |
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Telephone | 602-679-0020
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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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