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Organization
GROWTH SUPPORT ASSISTED LIVING LLC
Active
Organization
GROWTH SUPPORT ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIHAN A ABDULLE (OWNER)
(612) 702-0906
Entity
Organization
Contact information
Practice address
1928 PORTLAND AVE APT S101, MINNEAPOLIS, MN 55404-3469
(612) 702-0906
Mailing address
1928 PORTLAND AVE APT S101, MINNEAPOLIS, MN 55404-3469
(612) 702-0906
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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