Organization
LIFE JOURNEY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BISHARO JAAMAC YUSSUF (FOUNDER)
(612) 242-7843
Entity
Organization
Contact information
Practice address
1910 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3426
(612) 242-7843
Mailing address
1910 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3426
(612) 242-7843
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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