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General NPI Number Information
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NPI Number | 1841099504
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Entity Type | Organization
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Legal Business Name | SINCERE CONNECTIONS BEHAVIOR SUPPORT LLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 621 CLEVELAND AVE S STE 110
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City | SAINT PAUL
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State | MN
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Zip | 55116-3314
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Country | US
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Telephone | 612-735-4509
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 NORMANDALE LAKE BLVD STE 920
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City | BLOOMINGTON
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State | MN
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Zip | 55437-3843
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Country | US
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Telephone | 612-735-4509
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NAIMA MOHAMED
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Credential |
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Telephone | 612-735-4509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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