South East Homes Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1062832-1-CDT Issued in MN

Legal business name

SOUTH EAST HOMES INC

Practice address

2732 Bloomington Ave
Minneapolis, MN 55407-1146

Phone

(612) 702-7231

NPI assigned

May 26, 2011

Last updated

Aug 17, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Abah Abdul Mohamed, LADC

Title

John Prin

Phone

(612) 702-7231

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

SE Homes Recovery Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• SE Homes Recovery Inc

  dba South East Homes Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Minneapolis, MN
  • NPI 1437526720
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1336432087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044001",
            "telephone_number": "612-702-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2732 BLOOMINGTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071146",
            "telephone_number": "612-702-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EAST HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ABAH",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "JOHN PRIN",
        "authorized_official_telephone_number": "612-702-7231",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1062832-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS LICENSE",
            "identifier": "1058560",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benhoor Soumekh, MD
• Sound Connections Counseling (10,000 Licks LLC)
• Sound Mind Therapy
• Chad P Soupir, MD
• Source Healthcare, LLC
• South Metro Human Services Dba Radias Health
• South Metro Human Services Dba Radias Health
• South Metro Human Services Dba Radias Health
• South Metro Human Services Dba Radias Health
• South Metro Human Services Dba Radias Health

• Substance Abuse Rehabilitation Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.