Provider Demographics
NPI:1497298210
Name:SALAMS CARE RESIDENTIAL, LLC
Entity Type:Organization
Organization Name:SALAMS CARE RESIDENTIAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAAHO
Authorized Official - Middle Name:ABSHIR
Authorized Official - Last Name:ADAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-703-3545
Mailing Address - Street 1:2240 IDE CT
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2633
Mailing Address - Country:US
Mailing Address - Phone:651-528-6051
Mailing Address - Fax:651-528-6214
Practice Address - Street 1:2240 IDE CT
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109
Practice Address - Country:US
Practice Address - Phone:651-528-6051
Practice Address - Fax:651-528-6214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health