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General NPI Number Information
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NPI Number | 1881420735
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Entity Type | Organization
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Legal Business Name | FIRST LIGHT SERVICES INC
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 6001 78TH AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55443-2909
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Country | US
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Telephone | 612-703-3237
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 78TH AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55443-2909
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAJMA MOHAMED
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Credential |
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Telephone | 612-703-3237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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