Organization
PHOENIX NEST INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FASCIL BIRHANU DUBALE B.A (OWNER)
(612) 978-3940
Entity
Organization
Contact information
Practice address
2433 5TH AVE S APT 304, MINNEAPOLIS, MN 55404-3643
(612) 978-3940
Mailing address
2433 5TH AVE S APT 304, MINNEAPOLIS, MN 55404-3643
(612) 978-3940
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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