Midwest Residential INC

NPI #1578075750 in Bloomington, Minnesota

Provider Information

NPI Number: 1578075750
Entity Type: Organization
Organization Name: Midwest Residential INC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 28, 2017
Last Updated: Mar 18, 2024

Practice Location

Address: 10917 HUMBOLDT AVE S
City: Bloomington
State: Minnesota
ZIP Code: 55431-4221
Phone: (651) 315-2649

Authorized Official

Name: FAIZA HASSAN
Title: CEO
Phone: (651) 315-2649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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