Individual
MUSTAFA FARAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
(LALD)
Contact information
Practice address
3234 DUPONT AVE N, MINNEAPOLIS, MN 55412-2510
(612) 836-9799
(612) 448-0097
Mailing address
1901 STEVENS AVE APT 2, MINNEAPOLIS, MN 55403-3870
(612) 836-9799
Taxonomy
Speciality
Code
Description
License number
State
364SL0600X
Long-Term Care Clinical Nurse Specialist
1737
MN
374U00000X
Home Health Aide
1737
MN
376G00000X
Nursing Home Administrator
Primary
1737
MN
376J00000X
Homemaker
1737
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1737
MN BOARD OF EXECUTIVES FOR LONG-TERM SERVICES AND SUPPORTS
MN
Enumeration date
07/30/2025
Last updated
09/24/2025
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