Provider Demographics
NPI:1366715815
Name:HABBOON ADULT REHAB MENTAL SERVICES
Entity type:Organization
Organization Name:HABBOON ADULT REHAB MENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUAD
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-332-9005
Mailing Address - Street 1:808 BERRY ST STE# 192
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 BERRY ST STE# 192
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1082
Practice Address - Country:US
Practice Address - Phone:612-332-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)