Provider Demographics
NPI:1134576929
Name:MIDWEST MEDICAL & REHABILITATIVE SERVICES, LLC
Entity type:Organization
Organization Name:MIDWEST MEDICAL & REHABILITATIVE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAJMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-242-9796
Mailing Address - Street 1:7308 ASPEN LN N STE 134
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1035
Mailing Address - Country:US
Mailing Address - Phone:763-202-4322
Mailing Address - Fax:763-322-0417
Practice Address - Street 1:7308 ASPEN LN N STE 134
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-1035
Practice Address - Country:US
Practice Address - Phone:762-202-4322
Practice Address - Fax:763-322-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health