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NPI Code Detail

MEDICARE: ASPIRE RESTORATIVE CARE LLC

MEDICARE: ASPIRE RESTORATIVE 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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1336969757
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASPIRE RESTORATIVE CARE LLC
Provider Business Mailing Address
First Line : 2627 E FRANKLIN AVE STE 201
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-1168
Country : US
Telephone Number : 612-987-1297
Fax Number :
Provider Business Practice Location Address
First Line : 2627 E FRANKLIN AVE STE 201
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-1168
Country : US
Telephone Number : 612-987-1297
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ABDIFATAH ABDULLAHI YASIN
Credential :
Telephone Number : 612-987-1297
Provider Enumeration Date : 10/11/2024
Last Update Date : 10/11/2024

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Directions to “ASPIRE RESTORATIVE CARE LLC ” Practice Location

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