# BRIGHTWINGHOMES

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

## Provider details

- **NPI number:** 1336981323
- **Authorized official:** MAHOMED JIMCALE (DIRECTOR)
- **Authorized official phone:** (612) 438-6208

## Contact information

- **Practice address:** 19 8TH ST S \# 368, FARGO, ND 58103-1804
- **Practice address phone:** (612) 438-6208
- **Mailing address:** 19 8TH ST S \# 368, FARGO, ND 58103-1804
- **Mailing address phone:** (612) 438-6208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253J00000X | Foster Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 310400000X | Assisted Living Facility | — | NULL | — |

## Other

- **Enumeration date:** 06/10/2024
- **Last updated:** 06/10/2024