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General NPI Number Information
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NPI Number | 1235942657
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Entity Type | Organization
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Legal Business Name | COMMUNITY ENRICHMENT SERVICES LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 3721 HAZEL TRL UNIT B
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City | WOODBURY
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State | MN
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Zip | 55129-8340
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Country | US
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Telephone | 507-358-5122
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Fax |
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Provider Business Mailing Address
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Address Line | 7124 41ST ST N
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City | OAKDALE
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State | MN
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Zip | 55128-2600
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Country | US
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Telephone | 651-396-6951
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RUQUYO SAID
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Credential |
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Telephone | 507-358-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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