Organization
ELEGANT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASSAN M MOHAMED (MANAGER)
(763) 607-9377
Entity
Organization
Contact information
Practice address
260 WENTWORTH AVE E STE 105, WEST SAINT PAUL, MN 55118-3525
(763) 607-9377
Mailing address
260 WENTWORTH AVE E STE 105, WEST SAINT PAUL, MN 55118-3525
(763) 607-9377
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
06/19/2025
Last updated
06/19/2025
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