Organization
EXTENDED HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDI MOHAMED (OWNER)
(612) 517-7558
Entity
Organization
Contact information
Practice address
1928 PORTLAND AVE # S302, MINNEAPOLIS, MN 55404-3469
(612) 517-7558
Mailing address
8200 HUMBOLDT AVE S STE 219, BLOOMINGTON, MN 55431-1432
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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