Organization
LIBIN RESIDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABYAN KHALIF AHMED OWNER (OWNER)
(320) 291-9411
Entity
Organization
Contact information
Practice address
1504 13TH ST S, SAINT CLOUD, MN 56301-5418
(320) 291-9411
Mailing address
1504 13TH ST S, SAINT CLOUD, MN 56301-5418
(320) 291-9411
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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