MEDICARE: SPECTRUM STEPS THERAPY 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1346137817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM STEPS THERAPY LLC

Provider Business Mailing Address
First Line	:	8400 NORMANDALE LAKE BLVD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437-1085
Country	:	US
Telephone Number	:	612-756-6975
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 NORMANDALE LAKE BLVD STE 920
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437-3843
Country	:	US
Telephone Number	:	612-756-6975
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHO MOHAMED AHMED
Credential	:
Telephone Number	:	612-756-6975

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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