Healthcare Provider Details

I. General information

NPI: 1598488850
Provider Name (Legal Business Name): SAKURA THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 HUDSON BLVD N STE 111
OAKDALE MN
55128-7098
US

IV. Provider business mailing address

280 QUEENAN AVE S
LAKELAND MN
55043-9463
US

V. Phone/Fax

Practice location:
  • Phone: 651-448-2420
  • Fax: 651-448-2425
Mailing address:
  • Phone: 651-233-8966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY E TOKUDA
Title or Position: OWNER
Credential:
Phone: 651-233-8966