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General NPI Number Information
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NPI Number | 1073338331
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Entity Type | Organization
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Legal Business Name | PATH2POSSIBILITIES
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 3050 OLD HIGHWAY 8 APT 213
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City | ROSEVILLE
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State | MN
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Zip | 55113-1057
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Country | US
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Telephone | 952-769-3159
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 OLD HIGHWAY 8 APT 213
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City | ROSEVILLE
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State | MN
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Zip | 55113-1057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | C0-OWNER
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Name | ABDULLAHI YUSUF
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Credential |
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Telephone | 952-769-3159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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