Provider Demographics
NPI:1952155814
Name:ALLIANCE HEALTH CENTER LLC
Entity Type:Organization
Organization Name:ALLIANCE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIQAFAR
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-212-6037
Mailing Address - Street 1:2722 PARK AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1009
Mailing Address - Country:US
Mailing Address - Phone:952-212-6037
Mailing Address - Fax:
Practice Address - Street 1:2722 PARK AVE STE 211
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1009
Practice Address - Country:US
Practice Address - Phone:952-212-6037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center