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Organization

COMMUNITY BOARDING CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMED BIDARE DIRECTOR (OWNER)
(612) 296-3708
Entity
Organization

Contact information

Practice address
2219 OAKLAND AVE # 110, MINNEAPOLIS, MN 55404-3749
(612) 296-3708
Mailing address
2219 OAKLAND AVE # 110, MINNEAPOLIS, MN 55404-3749
(612) 296-3708

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
MN

Other

Enumeration date
04/24/2014
Last updated
04/24/2014
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