MEDICARE: BANADIR ADULT DAY CARE 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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1780127399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANADIR ADULT DAY CARE INC

Provider Business Mailing Address
First Line	:	8755 HILLSWICK TRL
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-1923
Country	:	US
Telephone Number	:	612-598-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 E LAKE ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1621
Country	:	US
Telephone Number	:	612-598-3333
Fax Number	:	612-249-5198

Authorized Official
Title or Position	:	CEO
Name	:	MR. AHMED A SAID
Credential	:
Telephone Number	:	612-598-3333

Provider Enumeration Date	:	11/30/2016
Last Update Date	:	11/30/2016

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