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General NPI Number Information
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NPI Number | 1578431268
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Entity Type | Organization
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Legal Business Name | JELLE CONSULTANT LLC
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Dates
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Enumeration Date | 10/25/2025
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Last Update Date | 10/25/2025
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Provider Practice Location Address
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Address Line | 1517 PATRICIA DR
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4969
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Country | US
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Telephone | 612-913-8134
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 PATRICIA DR
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4969
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Country | US
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Telephone | 612-913-8134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUSSEIN AHMED
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Credential |
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Telephone | 612-913-8134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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