Southwest Residence Center INC
NPI #1023826179 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1023826179
- Entity Type
- Organization
- Organization Name
- Southwest Residence Center INC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Dec 20, 2024
- Last Updated
- Dec 20, 2024
Practice Location
- Address
- 9400 COLUMBUS AVE S
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55420-4528
- Phone
- (952) 994-0998
Authorized Official
- Name
- FAHAF DUNKAL
- Title
- OWNER
- Phone
- (952) 994-0998
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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