Provider Demographics
NPI:1043043607
Name:HOUSING SUPPORT CENTER LLC
Entity type:Organization
Organization Name:HOUSING SUPPORT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKADIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHEIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-329-0885
Mailing Address - Street 1:1132 28TH AVE S STE 104
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-4420
Mailing Address - Country:US
Mailing Address - Phone:218-329-0885
Mailing Address - Fax:
Practice Address - Street 1:1132 28TH AVE S STE 104
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-4420
Practice Address - Country:US
Practice Address - Phone:218-329-0885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center