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General NPI Number Information
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NPI Number | 1992475685
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Entity Type | Organization
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Legal Business Name | AATRIA HEALTHCARE LLC
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 2355 HIGHWAY 36 W
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City | ROSEVILLE
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State | MN
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Zip | 55113-3902
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Country | US
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Telephone | 612-599-6445
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Fax |
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Provider Business Mailing Address
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Address Line | 2355 HIGHWAY 36 W STE 400
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City | ROSEVILLE
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State | MN
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Zip | 55113-3905
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Country | US
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Telephone | 612-599-6445
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | FAISO ADEN ABDULLE
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Credential | RN, CNP
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Telephone | 612-599-6445
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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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