Provider Demographics
NPI:1477740215
Name:A&R OPEN DOOR INC
Entity Type:Organization
Organization Name:A&R OPEN DOOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ACKIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAMANKULI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-519-1159
Mailing Address - Street 1:14215 46TH PL N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3494
Mailing Address - Country:US
Mailing Address - Phone:763-519-1159
Mailing Address - Fax:763-519-0061
Practice Address - Street 1:14215 46TH PL N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3494
Practice Address - Country:US
Practice Address - Phone:763-519-1159
Practice Address - Fax:763-519-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN337757310400000X
MN337754310400000X
MN337518311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility