=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245071695
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UP TOP COMMUNITY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2024
-----------------------------------------------------
Last Update Date | 03/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 JACKSON AVE N STE 168
-----------------------------------------------------
City | HOPKINS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55343-8583
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-987-8695
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 175 JACKSON AVE N STE 168
-----------------------------------------------------
City | HOPKINS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55343-8583
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-987-8695
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZE/OWNER
-----------------------------------------------------
Name | HANAN ABDI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 612-237-0043
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------