MEDICARE: AMAANA ADULT DAY CARE 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1548552219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAANA ADULT DAY CARE CENTER INC

Provider Business Mailing Address
First Line	:	1312 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1630
Country	:	US
Telephone Number	:	952-457-0363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1312 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1630
Country	:	US
Telephone Number	:	952-457-0363
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ABDULQADIR HASSAN
Credential	:
Telephone Number	:	952-457-0363

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	09/27/2016

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