Organization
GIIR HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUSTAFA HASSAN AHMED (DIRECTOR)
(952) 220-9158
Entity
Organization
Contact information
Practice address
2910 PILLSBURY AVE S, MINNEAPOLIS, MN 55408-2297
(952) 220-9158
(612) 465-5750
Mailing address
2910 PILLSBURY AVE S, MINNEAPOLIS, MN 55408-2297
(952) 220-9158
(612) 465-5750
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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