OrganizationActive
Midwest Residential Inc
NPI 1578075750 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Bloomington, MN
Provider details
- NPI number
- 1578075750
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Faiza Hassan, Ceo(651) 315-2649
- License
- 381821 (MN)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 381821 (MN)
Residential Treatment Facilities
Practice location
10917 Humboldt Ave S
Bloomington, MN 55431-4221
Phone: (651) 315-2649
Approximate (ZIP-level) locationGet directions
Mailing address
7400 Cedar Ave S
Minneapolis, MN 55423-4647
Additional practice locations (4)
- 10449 Johnson Ave SBloomington, MN 55437-2819Phone: (651) 315-2649Fax: (612) 979-2604
- 10325 Zinran Ave SBloomington, MN 55438-1961Phone: (651) 315-2649
- 5620 W 99th StBloomington, MN 55437-2227Phone: (651) 315-2649Fax: (612) 979-2604
- 7800 W 101st StBloomington, MN 55438-2071Phone: (651) 315-2649Fax: (612) 979-2604
Registry dates
- Enumerated
- 2017-10-28
- Last updated
- 2024-03-18
- Certified
- 2024-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.