Healthcare Provider Details
I. General information
NPI: 1801620075
Provider Name (Legal Business Name): TOCARE WELLNESS CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2024
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8001 33RD AVE S UNIT B431
BLOOMINGTON MN
55425-4651
US
IV. Provider business mailing address
8001 33RD AVE S UNIT B431
BLOOMINGTON MN
55425-4651
US
V. Phone/Fax
- Phone: 952-393-0505
- Fax:
- Phone: 952-393-0505
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NASRO
A
AHMED
Title or Position: FAMILY/PSYCHIATRY NURSE PRACTIONER
Credential: DNP, FNP-C, PMHNP-BC
Phone: 952-393-0505