Organization
BRIGHTWINGHOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHOMED JIMCALE (DIRECTOR)
(612) 438-6208
Entity
Organization
Contact information
Practice address
19 8TH ST S # 368, FARGO, ND 58103-1804
(612) 438-6208
Mailing address
19 8TH ST S # 368, FARGO, ND 58103-1804
(612) 438-6208
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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