# MK ASSISTED LIVING IJNC

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

## Provider details

- **NPI number:** 1316814254
- **Authorized official:** SAMATAR FARAH (DIRECTOR)
- **Authorized official phone:** (952) 245-3016

## Contact information

- **Practice address:** 10525 LYNDALE AVE S, BLOOMINGTON, MN 55420-5240
- **Practice address phone:** (952) 245-3016
- **Mailing address:** 10525 LYNDALE AVE S, BLOOMINGTON, MN 55420-5240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2025
- **Last updated:** 10/23/2025