Organization
PLATEAU HEALTHCARE LLC
Active
Other names
PHC Community
Organization subpart
No
Provider details
NPI number
Authorized official
FAISALE SALE BOUKARI (PRESIDENT)
(763) 444-1361
Entity
Organization
Contact information
Practice address
6424 JUNE AVE N, BROOKLYN CENTER, MN 55429-2127
(763) 444-1361
(763) 444-1358
Mailing address
8848 ZEALAND AVE N STE B, BROOKLYN PARK, MN 55445-1891
(763) 444-1361
(763) 444-1358
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
352764
MN
251J00000X
Nursing Care Agency
352764
MN
251J00000X
Nursing Care Agency
Primary
372551
MN
253Z00000X
In Home Supportive Care Agency
353611
MN
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
07/09/2010
Last updated
04/28/2023
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