Provider Demographics
NPI:1619776325
Name:ALTITUDE LIVING INC
Entity type:Organization
Organization Name:ALTITUDE LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIYAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-246-2283
Mailing Address - Street 1:6109 BLUE CIRCLE DR STE 1000
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5681 277TH ST
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MN
Practice Address - Zip Code:55092-9364
Practice Address - Country:US
Practice Address - Phone:612-246-2283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health