Organization
SIIDOW HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NALAYE MOHAMOUD ISMAIL OWNER (MANAGER)
(320) 224-6140
Entity
Organization
Contact information
Practice address
810 4TH AVE S, SUITE 100, MOORHEAD, MN 56560
(320) 224-6140
Mailing address
810 4TH AVE S STE 100, MOORHEAD, MN 56560-2800
(320) 224-6140
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
ISM905072
ND
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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