Provider Demographics
NPI:1710713227
Name:KHAIR RECOVERY CENTER INC.
Entity type:Organization
Organization Name:KHAIR RECOVERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUHAYLA
Authorized Official - Middle Name:FARXAN
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-529-8769
Mailing Address - Street 1:5100 W 82ND ST APT 385
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-1573
Mailing Address - Country:US
Mailing Address - Phone:952-529-8769
Mailing Address - Fax:
Practice Address - Street 1:8937 AZTEC DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-2635
Practice Address - Country:US
Practice Address - Phone:952-529-8769
Practice Address - Fax:612-545-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health