Provider Demographics
NPI:1043082811
Name:HIDAYA CENTER
Entity Type:Organization
Organization Name:HIDAYA CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KHADRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-226-9300
Mailing Address - Street 1:4111 CENTRAL AVE NE STE 208E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2989
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4111 CENTRAL AVE NE STE 208E
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2989
Practice Address - Country:US
Practice Address - Phone:612-226-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health