| Southwest Residence Center Inc | |
|
9400 Columbus Ave S Bloomington MN 55420-4528 | |
| (952) 994-0998 | |
| Not Available |
| Full Name | Southwest Residence Center Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 9400 Columbus Ave S, Bloomington, Minnesota |
| Authorized Official Name and Position | Fahaf Dunkal (OWNER) |
| Authorized Official Contact | 9529940998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Residence Center Inc 9400 Columbus Ave S Bloomington MN 55420-4528 Ph: () - | Southwest Residence Center Inc 9400 Columbus Ave S Bloomington MN 55420-4528 Ph: (952) 994-0998 |
| NPI Number | 1023826179 |
|---|---|
| Provider Enumeration Date | 12/20/2024 |
| Last Update Date | 12/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023826179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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