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NPI Code Detail

MEDICARE: SAFECREST HOUSING LLC

MEDICARE: SAFECREST HOUSING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1174328868
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAFECREST HOUSING LLC
Provider Business Mailing Address
First Line : 5350 GREYSTONE DR APT 105
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1749
Country : US
Telephone Number : 804-803-4678
Fax Number :
Provider Business Practice Location Address
First Line : 5350 GREYSTONE DR APT 105
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1749
Country : US
Telephone Number : 804-803-4678
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ABDULLAHI ALI FARAH
Credential :
Telephone Number : 804-803-4678
Provider Enumeration Date : 02/17/2025
Last Update Date : 02/17/2025

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Directions to “SAFECREST HOUSING LLC ” Practice Location

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