Healthcare Provider Details

I. General information

NPI: 1427897966
Provider Name (Legal Business Name): CORE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 66TH ST STE 101
RICHFIELD MN
55423-2685
US

IV. Provider business mailing address

1300 E 66TH ST STE 101
RICHFIELD MN
55423-2685
US

V. Phone/Fax

Practice location:
  • Phone: 612-297-0747
  • Fax: 612-452-4040
Mailing address:
  • Phone: 612-297-0747
  • Fax: 612-452-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: YASIN KODAH
Title or Position: MANAGER
Credential:
Phone: 612-383-2927