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NPI Code Detail

MEDICARE: MINDFUL THERAPEUTICS CARE LLC

MEDICARE: MINDFUL THERAPEUTICS CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1306595004
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINDFUL THERAPEUTICS CARE LLC
Provider Business Mailing Address
First Line : 8400 NORMANDALE LAKE BLVD STE 920
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-3843
Country : US
Telephone Number : 612-500-1368
Fax Number :
Provider Business Practice Location Address
First Line : 8400 NORMANDALE LAKE BLVD STE 920
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-3843
Country : US
Telephone Number : 612-500-1368
Fax Number :
Authorized Official
Title or Position : COO
Name : SAMIRA ABDLLE
Credential :
Telephone Number : 612-500-1368
Provider Enumeration Date : 03/21/2022
Last Update Date : 03/21/2022

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Directions to “MINDFUL THERAPEUTICS CARE LLC ” Practice Location

Language Start Address Practice Location
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