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Organization

EBYAN ADULT DAY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ADAM ISSE ALI I (OWNER/PRESEDENT)
(612) 313-0733
Entity
Organization

Contact information

Practice address
1810 RIVERSIDE AVE # LL, MINNEAPOLIS, MN 55454-1031
(612) 313-0733
(612) 313-8144
Mailing address
1810 RIVERSIDE AVE # LL, MINNEAPOLIS, MN 55454-1031
(612) 313-0733
(612) 313-8144

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1049972-4-ADC
MN

Other

Enumeration date
12/01/2011
Last updated
12/14/2011
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