Healthcare Provider Details

I. General information

NPI: 1043072234
Provider Name (Legal Business Name): AURA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6499 UNIVERSITY AVE NE
FRIDLEY MN
55432-4303
US

IV. Provider business mailing address

6499 UNIVERSITY AVE NE
FRIDLEY MN
55432-4303
US

V. Phone/Fax

Practice location:
  • Phone: 612-486-2134
  • Fax:
Mailing address:
  • Phone: 612-486-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAMS MOHAMED ALI
Title or Position: CEO
Credential:
Phone: 612-486-2134