Provider Demographics
NPI:1104641406
Name:SPES RESIDENTIAL CARE L. L. C.
Entity type:Organization
Organization Name:SPES RESIDENTIAL CARE L. L. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARMAAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJIHUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-481-7156
Mailing Address - Street 1:6704 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2351
Mailing Address - Country:US
Mailing Address - Phone:612-404-7208
Mailing Address - Fax:
Practice Address - Street 1:6336 WILRYAN AVE
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-1444
Practice Address - Country:US
Practice Address - Phone:612-404-7208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility