Healthcare Provider Details

I. General information

NPI: 1972323780
Provider Name (Legal Business Name): TRUWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 W LAKE ST STE 224
MINNEAPOLIS MN
55408-2502
US

IV. Provider business mailing address

1516 W LAKE ST STE 224
MINNEAPOLIS MN
55408-2502
US

V. Phone/Fax

Practice location:
  • Phone: 612-234-1533
  • Fax:
Mailing address:
  • Phone: 612-234-1533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZAKARIA SULEMAN
Title or Position: MANAGER
Credential:
Phone: 612-234-1533