Healthcare Provider Details

I. General information

NPI: 1821294372
Provider Name (Legal Business Name): SAFETY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 LYNDALE AVE S STE 75
BLOOMINGTON MN
55420-0010
US

IV. Provider business mailing address

10800 LYNDALE AVE S STE 75
BLOOMINGTON MN
55420-0010
US

V. Phone/Fax

Practice location:
  • Phone: 952-884-4882
  • Fax: 952-884-0284
Mailing address:
  • Phone: 952-884-4882
  • Fax: 952-884-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA BLOOM
Title or Position: DIRECTOR OF COUNSELING
Credential: MA, LPCC
Phone: 952-884-4882