Organization
612 MASH INCORPORATED
Active
Organization
612 MASH INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MABLE FALE (EXECUTIVE DIRECTOR)
(320) 774-8694
Entity
Organization
Contact information
Practice address
730 E 38TH ST STE 100, MINNEAPOLIS, MN 55407-5218
(612) 598-0338
Mailing address
730 E 38TH ST STE 100, MINNEAPOLIS, MN 55407-5218
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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