Healthcare Provider Details

I. General information

NPI: 1740061985
Provider Name (Legal Business Name): TNT WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2136 FORD PKWY
SAINT PAUL MN
55116-2850
US

IV. Provider business mailing address

2669 COON RAPIDS BLVD NW
COON RAPIDS MN
55433-0001
US

V. Phone/Fax

Practice location:
  • Phone: 702-900-8832
  • Fax:
Mailing address:
  • Phone: 612-388-7488
  • 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: JULIOUS HEATH
Title or Position: CHIEF INTEL OFFICER
Credential:
Phone: 702-900-8832