Provider Demographics
NPI:1689350654
Name:ACCORD CARE SERVICE
Entity Type:Organization
Organization Name:ACCORD CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAZAK
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BOTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-251-8122
Mailing Address - Street 1:401 LOOKOUT PLACE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421
Mailing Address - Country:US
Mailing Address - Phone:612-251-8122
Mailing Address - Fax:
Practice Address - Street 1:401 LOOKOUT PLACE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421
Practice Address - Country:US
Practice Address - Phone:612-251-8122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management