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General NPI Number Information
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NPI Number | 1053204933
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Entity Type | Organization
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Legal Business Name | HOPE THERAPY SERVICE LLC
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 12119 16TH AVE S # 105
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City | BURNSVILLE
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State | MN
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Zip | 55337-2982
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Country | US
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Telephone | 612-388-0017
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Fax |
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Provider Business Mailing Address
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Address Line | 12119 16TH AVE S STE 105
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City | BURNSVILLE
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State | MN
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Zip | 55337-2982
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Country | US
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Telephone | 612-388-0017
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SAID HASSAN ABDULATIF
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Credential |
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Telephone | 612-388-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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