Organization
HAC EXTENDED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSHIN ALI (PRESIDENT)
(612) 757-6640
Entity
Organization
Contact information
Practice address
2021 E HENNEPIN AVE STE 418B, MINNEAPOLIS, MN 55413-2700
(612) 757-6640
Mailing address
2021 E HENNEPIN AVE STE 418B, MINNEAPOLIS, MN 55413-2700
(612) 757-6640
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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