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General NPI Number Information
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NPI Number | 1245092485
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Entity Type | Organization
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Legal Business Name | OPEN MIND CENTER LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 4124 QUEBEC AVE N STE 107
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City | NEW HOPE
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State | MN
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Zip | 55427-1200
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Country | US
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Telephone | 612-859-1532
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Fax |
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Provider Business Mailing Address
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Address Line | 4124 QUEBEC AVE N STE 107
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City | NEW HOPE
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State | MN
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Zip | 55427-1200
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Country | US
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Telephone | 612-859-1532
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MUBRAIG JAMA
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Credential |
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Telephone | 612-532-6087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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