Provider Demographics
NPI:1659755312
Name:IMMIGRANT WOMEN AND CHILDREN DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:IMMIGRANT WOMEN AND CHILDREN DEVELOPMENT CENTER
Other - Org Name:MIDWEST COMMUNITY DEVELOPMENT INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FOUNDER & EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-298-5754
Mailing Address - Street 1:308 PRINCE ST
Mailing Address - Street 2:SUITE 258
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1476
Mailing Address - Country:US
Mailing Address - Phone:612-298-5754
Mailing Address - Fax:
Practice Address - Street 1:308 PRINCE STREET
Practice Address - Street 2:SUITE #258
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1476
Practice Address - Country:US
Practice Address - Phone:612-298-5754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty