MEDICARE: SOMALI FAMILY AND YOUTH SERVICES

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	251V00000X	Voluntary or Charitable Agency		MN

General Provider Information

NPI Number	:	1316136203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMALI FAMILY AND YOUTH SERVICES

Provider Business Mailing Address
First Line	:	310 E 38TH ST
Second Line	:	SUITE G.
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-252-2416
Fax Number	:	612-252-2412

Provider Business Practice Location Address
First Line	:	310 E 38TH ST
Second Line	:	SUITE G.
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-252-2416
Fax Number	:	612-252-2412

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SAEED H JAMA
Credential	:
Telephone Number	:	612-227-9249

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	10/17/2007

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Directions to “SOMALI FAMILY AND YOUTH SERVICES ” Practice Location

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