Provider Demographics
NPI:1053772939
Name:ISKA INC
Entity type:Organization
Organization Name:ISKA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IFRAH
Authorized Official - Middle Name:ABDI
Authorized Official - Last Name:HUDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-888-7055
Mailing Address - Street 1:4236 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1432
Mailing Address - Country:US
Mailing Address - Phone:612-636-7188
Mailing Address - Fax:612-605-3312
Practice Address - Street 1:4236 PARK GLEN RD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-636-7188
Practice Address - Fax:612-605-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12133251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services