Provider Demographics
NPI:1538910112
Name:NIMO LIVING SERVICES
Entity type:Organization
Organization Name:NIMO LIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIMO
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-367-2429
Mailing Address - Street 1:3809 42ND AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3503
Mailing Address - Country:US
Mailing Address - Phone:952-367-2429
Mailing Address - Fax:612-200-3119
Practice Address - Street 1:3809 42ND AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3503
Practice Address - Country:US
Practice Address - Phone:952-367-2429
Practice Address - Fax:612-200-3119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NIMO LIVING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty