MEDICARE: WE CARE RECOVERY CENTER, INC

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1447032628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE CARE RECOVERY CENTER, INC

Provider Business Mailing Address
First Line	:	8030 OLD CEDAR AVE S STE 110
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-1214
Country	:	US
Telephone Number	:	651-502-4638
Fax Number	:	952-426-4935

Provider Business Practice Location Address
First Line	:	8030 OLD CEDAR AVE S STE 110
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-1214
Country	:	US
Telephone Number	:	651-502-4638
Fax Number	:	952-426-4935

Authorized Official
Title or Position	:	CEO
Name	:	HUSSEIN DAUD
Credential	:
Telephone Number	:	651-502-4638

Provider Enumeration Date	:	10/20/2023
Last Update Date	:	10/20/2023

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