Provider Demographics
NPI:1457650004
Name:AFRICAN FAMILIES DEVELOPMENT NETWORK
Entity Type:Organization
Organization Name:AFRICAN FAMILIES DEVELOPMENT NETWORK
Other - Org Name:AFDN
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MOHAMOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-724-0000
Mailing Address - Street 1:2446 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3938
Mailing Address - Country:US
Mailing Address - Phone:612-724-0000
Mailing Address - Fax:612-844-2775
Practice Address - Street 1:3207 CEDAR AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3802
Practice Address - Country:US
Practice Address - Phone:612-724-0000
Practice Address - Fax:612-844-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNM787425000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health