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General NPI Number Information
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NPI Number | 1265165542
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Entity Type | Organization
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Legal Business Name | INCLUSIVE THERAPY CENTER LLC
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 7800 METRO PKWY STE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1509
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Country | US
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Telephone | 952-688-2459
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Fax |
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Provider Business Mailing Address
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Address Line | 7800 METRO PKWY STE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1509
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Country | US
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Telephone | 952-688-2459
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMIRA SAID ABDULLAHI
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Credential |
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Telephone | 952-688-2459
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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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