MEDICARE: AMANA HEALING CENTER 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1184470569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANA HEALING CENTER LLC

Provider Business Mailing Address
First Line	:	1736 PENN AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3054
Country	:	US
Telephone Number	:	651-410-3360
Fax Number	:

Provider Business Practice Location Address
First Line	:	1736 PENN AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55411-3054
Country	:	US
Telephone Number	:	651-410-3360
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADNAN KHAN
Credential	:
Telephone Number	:	651-410-3360

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	04/26/2024

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Directions to “AMANA HEALING CENTER LLC ” Practice Location

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