| Midwest Community Support, Inc. | |
|
7900 Excelsior Blvd Ste 2015 Hopkins MN 55343-2600 | |
| (612) 533-3030 | |
| (952) 426-1367 |
| Full Name | Midwest Community Support, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 7900 Excelsior Blvd Ste 2015, Hopkins, Minnesota |
| Authorized Official Name and Position | Suad Bashir Jama (PRESIDENT/CEO) |
| Authorized Official Contact | 7633639004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Community Support, Inc. 7900 Excelsior Blvd Ste 2015 Hopkins MN 55343-2600 Ph: (763) 363-9004 | Midwest Community Support, Inc. 7900 Excelsior Blvd Ste 2015 Hopkins MN 55343-2600 Ph: (612) 533-3030 |
| NPI Number | 1184288268 |
|---|---|
| Provider Enumeration Date | 04/24/2019 |
| Last Update Date | 03/03/2023 |
| Certification Date | 03/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184288268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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