MEDICARE: EBYAN ADULT DAY CENTER LLC

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	1049972-4-ADC	MN

General Provider Information

NPI Number	:	1801164108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EBYAN ADULT DAY CENTER LLC

Provider Business Mailing Address
First Line	:	1810 RIVERSIDE AVE # LL
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1031
Country	:	US
Telephone Number	:	612-313-0733
Fax Number	:	612-313-8144

Provider Business Practice Location Address
First Line	:	1810 RIVERSIDE AVE # LL
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1031
Country	:	US
Telephone Number	:	612-313-0733
Fax Number	:	612-313-8144

Authorized Official
Title or Position	:	OWNER/PRESEDENT
Name	:	MR. ADAM ISSE ALI I
Credential	:
Telephone Number	:	612-313-0733

Provider Enumeration Date	:	12/01/2011
Last Update Date	:	12/14/2011

Similar Medicare Providers

1487138673 — TUCKER J ANNIS
Practice Location Address:

1619 GRAND ST NE
MINNEAPOLIS, MN
55413-1031

Practice Phone: 715-892-8888
Practice Fax:

1740115559 — SOFIA MILLER
Practice Location Address:

2450 RIVERSIDE AVE
MINNEAPOLIS, MN
55454-1450

Practice Phone: 612-624-4477
Practice Fax:

1881881035 — RUTH MUSHIMBWA HAAMANKULI DNP, FNP
Practice Location Address:

425 20TH AVE S
MINNEAPOLIS, MN
55454-4400

Practice Phone: 612-332-4973
Practice Fax: 612-238-3534

1063347425 — KAYLA WIMMER
Practice Location Address:

2450 RIVERSIDE AVE
MINNEAPOLIS, MN
55454-1450

Practice Phone: 320-339-1177
Practice Fax:

1710812953 — ANDREAS STEWART-FINKENSTAEDT
Practice Location Address:

2450 RIVERSIDE AVE
MINNEAPOLIS, MN
55454-1450

Practice Phone: 612-273-6062
Practice Fax:

1114620721 — SAMANTHA CONSIDINE PEZON MD
Practice Location Address:

PEDS EDUCATION OFFICE M136, 1ST FLOOR, EAST BUILDING , 2540 RIVERSIDE AVE
MINNEAPOLIS, MN
55454

Practice Phone: 612-624-4477
Practice Fax:

Directions to “EBYAN ADULT DAY CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.