Organization
NASIYE GROUP HOME CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIYAN ALI JAMA (OWNER)
(612) 205-9142
Entity
Organization
Contact information
Practice address
3913 4TH AVE S, MINNEAPOLIS, MN 55409-1614
(612) 205-9142
Mailing address
3913 4TH AVE S, MINNEAPOLIS, MN 55409-1614
(612) 205-9142
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
11/28/2019
Last updated
11/28/2019
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