Organization
SERENITY CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADUMO MOHAMED MOHAMED OWNER (MANAGER)
(612) 242-0517
Entity
Organization
Contact information
Practice address
1601 MN-13E, 204, BURNSVILLE, MN 55337-2917
(612) 242-0517
Mailing address
1601 MN-13 N, SUITE 204, BURNSVILLE, MN 55337-2172
(612) 242-0517
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
AUTISM CENTER
MN
Enumeration date
02/02/2023
Last updated
05/10/2024
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