Provider Demographics
NPI:1528780061
Name:SEED SENIOR LIVING
Entity type:Organization
Organization Name:SEED SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOUSE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FARTUN
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:ROBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-395-2470
Mailing Address - Street 1:5422 W OLD SHAKOPEE CIR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-2766
Mailing Address - Country:US
Mailing Address - Phone:952-395-2470
Mailing Address - Fax:952-443-8604
Practice Address - Street 1:5422 W OLD SHAKOPEE CIR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-2766
Practice Address - Country:US
Practice Address - Phone:952-395-2470
Practice Address - Fax:952-443-8604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness