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General NPI Number Information
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NPI Number | 1386357929
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Entity Type | Organization
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Legal Business Name | MARTIN CENTER FOR INTEGRATION LLC
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 3204 E 43RD ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-3858
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Country | US
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Telephone | 651-300-2150
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Fax | 651-478-2223
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Provider Business Mailing Address
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Address Line | 3204 E 43RD ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-3858
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Country | US
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Telephone | 651-300-2150
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Fax | 651-478-2223
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Authorized Official
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Title or Position | CO-OWNER, DIRECTOR OF OPERATIONS
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Name | TIMOTHY PATRICK MILLEA II
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Credential |
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Telephone | 651-300-2150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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