Provider Demographics
NPI:1801407234
Name:BANADIR HEALTH SERVICES
Entity Type:Organization
Organization Name:BANADIR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SABRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:507-202-6739
Mailing Address - Street 1:110 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4216
Mailing Address - Country:US
Mailing Address - Phone:612-353-5639
Mailing Address - Fax:
Practice Address - Street 1:110 W 26TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4216
Practice Address - Country:US
Practice Address - Phone:612-353-5639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)