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NPI Code Detail

MEDICARE: KHAIR RECOVERY CENTER INC.

MEDICARE: KHAIR 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1710713227
Entity Type Code : Organization
Provider Name (Legal Business Name) : KHAIR RECOVERY CENTER INC.
Provider Business Mailing Address
First Line : 5100 W 82ND ST APT 385
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-1573
Country : US
Telephone Number : 952-529-8769
Fax Number :
Provider Business Practice Location Address
First Line : 8937 AZTEC DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55347-2635
Country : US
Telephone Number : 952-529-8769
Fax Number : 612-545-0101
Authorized Official
Title or Position : CEO
Name : MRS. SUHAYLA FARXAN MOHAMUD
Credential :
Telephone Number : 952-529-8769
Provider Enumeration Date : 09/11/2024
Last Update Date : 05/06/2025

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Directions to “KHAIR RECOVERY CENTER INC. ” Practice Location

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