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Organization

ADVANCE SUPPORT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BALLE WARSAME (PRESIDENT)
(612) 242-1893
Entity
Organization

Contact information

Practice address
3055 OLD HIGHWAY 8 STE 101A, SAINT ANTHONY, MN 55418-2500
(612) 242-1893
Mailing address
3055 OLD HIGHWAY 8 STE 101A, SAINT ANTHONY, MN 55418-2500
(612) 242-1893

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02
MENTAL HEALTH
MN
Enumeration date
05/10/2019
Last updated
05/10/2019
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