Provider Demographics
NPI:1114755386
Name:MIDWEST STABILIZATION SERVICES INC
Entity type:Organization
Organization Name:MIDWEST STABILIZATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDINUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-417-3001
Mailing Address - Street 1:1845 UNIVERSITY AVE W UNIT W415
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1845 UNIVERSITY AVE W UNIT W415
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4563
Practice Address - Country:US
Practice Address - Phone:651-417-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage