Organization
REDESIGN LIFESTYLE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAMDI ALI MOHAMED (OWNER)
(612) 963-2576
Entity
Organization
Contact information
Practice address
1527 MORGAN AVE N, MINNEAPOLIS, MN 55411-3013
(612) 963-2576
(612) 238-8055
Mailing address
4725 MINNETONKA BLVD APT 301, SAINT LOUIS PARK, MN 55416-2240
(612) 963-2576
(612) 238-8055
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35034
HFID #
MN
01
—
36065
HFID #
MN
01
—
394113
TEMPORARY COMPREHENSIVE HOME CARE LICENSE NUMBER
MN
01
—
395890
HOUSING WITH SERVICES
MN
Enumeration date
04/21/2020
Last updated
04/21/2020
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