MIDWEST RESIDENTIAL INC NPI 1578075750

NPI Information

MIDWEST RESIDENTIAL INC is a residential treatment facility, intellectual and/or developmental disabilities in Bloomington, MN. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. MIDWEST RESIDENTIAL INC NPI is 1578075750. The provider is registered as an organization entity type.

The provider's business location address is:

10917 HUMBOLDT AVE S
BLOOMINGTON, MN
ZIP 55431-221
Phone: (651) 315-2649

The provider's authorized official is Faiza Hassan .
The authorized official title is Ceo and has the following contact phone number (651) 315-2649.

The CLIA number assigned to this NPI record is 24D2146918 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/28/2017 and was last updated on 3/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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