Healthcare Provider Details

I. General information

NPI: 1588470983
Provider Name (Legal Business Name): ADIL CHILD THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 UNIVERSITY AVE W STE 261-5
SAINT PAUL MN
55104-2928
US

IV. Provider business mailing address

1821 UNIVERSITY AVE W STE 261-5
SAINT PAUL MN
55104-2928
US

V. Phone/Fax

Practice location:
  • Phone: 612-481-6172
  • Fax: 612-444-8834
Mailing address:
  • Phone: 612-481-6172
  • Fax: 612-444-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FARTUN ABASS OSMAN
Title or Position: CEO
Credential: RN
Phone: 612-481-6172