Provider Demographics
NPI:1477004497
Name:KAIRE LLC
Entity Type:Organization
Organization Name:KAIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAADIO
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-703-5901
Mailing Address - Street 1:100 WARREN ST STE 316
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3762
Mailing Address - Country:US
Mailing Address - Phone:763-703-5901
Mailing Address - Fax:763-762-7668
Practice Address - Street 1:100 WARREN ST STE 316
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3762
Practice Address - Country:US
Practice Address - Phone:763-703-5901
Practice Address - Fax:763-762-7668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAIRE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-14
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN863056000021251S00000X
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health