Organization
KIDS SPACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUSAMED M. HASSEN (OWNER)
(612) 800-4509
Entity
Organization
Contact information
Practice address
1440 85TH AVE NE UNIT D, SPRING LAKE PARK, MN 55432-1323
(612) 800-4509
Mailing address
1440 85TH AVE NE UNIT D, SPRING LAKE PARK, MN 55432-1323
(612) 800-4509
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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