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General NPI Number Information
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NPI Number | 1609664184
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Entity Type | Organization
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Legal Business Name | BRAINSTORM BEHAVIORAL SERVICES L.L.C.
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 2901 E 25TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2999
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Country | US
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Telephone | 313-409-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 E 25TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2999
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Country | US
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Telephone | 313-409-1252
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Fax |
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Authorized Official
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Title or Position | OWNER / PMHNP
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Name | JACOB ALLEN ROBINSON
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Credential |
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Telephone | 313-409-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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