# KIDCARE VENUE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194413344
- **Authorized official:** UBAH A YUSUF (OWNER)
- **Authorized official phone:** (612) 607-4412

## Contact information

- **Practice address:** 3226 29TH AVE NE, MINNEAPOLIS, MN 55418-3241
- **Practice address phone:** (612) 607-4412
- **Mailing address:** 3055 OLD HIGHWAY 8 STE 215, MINNEAPOLIS, MN 55418-2492
- **Mailing address phone:** (612) 607-4412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/26/2023
- **Last updated:** 04/26/2023