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General NPI Number Information
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NPI Number | 1275115743
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Entity Type | Organization
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Legal Business Name | GIANT STEPS CENTER LLC
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Dates
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Enumeration Date | 04/24/2021
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Last Update Date | 04/24/2021
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Provider Practice Location Address
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Address Line | 2642 UNIVERSITY AVE W STE 115
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City | SAINT PAUL
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State | MN
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Zip | 55114-1032
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Country | US
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Telephone | 952-232-6712
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 87TH TRL N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-3733
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Country | US
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Telephone | 952-232-6712
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HIBO ELMI
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Credential |
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Telephone | 952-232-6710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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