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Organization

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Active
Parent organization
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Other names
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Organization subpart
Yes

Provider details

NPI number
Legal business name
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Authorized official
LAMIN LAMIN DIBBA (AUTHORIZED OFFICIAL)
(612) 986-6412
Entity
Organization

Contact information

Practice address
16700 50TH CT N, PLYMOUTH, MN 55446-4532
(612) 986-6412
Mailing address
16700 50TH CT N, PLYMOUTH, MN 55446-4532
(612) 986-6412

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
03/21/2022
Last updated
03/21/2022
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