Organization
MSAADA LLC
Active
Other names
LOGO Community Support Services
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANNE JANNIBAH GOULD (CEO)
(763) 501-2326
Entity
Organization
Contact information
Practice address
5919 ABBOTT AVE N, BROOKLYN CENTER, MN 55429-2626
(763) 501-2326
Mailing address
5919 ABBOTT AVE N, BROOKLYN CENTER, MN 55429-2626
(763) 501-2326
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A561937000
—
MN
Enumeration date
04/14/2022
Last updated
04/14/2022
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