MEDICARE: DUA HEALTH SERVICES 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	:	1376312488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUA HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	322 W LAKE ST STE 214
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-5202
Country	:	US
Telephone Number	:	952-652-7553
Fax Number	:

Provider Business Practice Location Address
First Line	:	322 W LAKE ST STE 214
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-5202
Country	:	US
Telephone Number	:	952-652-7553
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	UMULKHAYR OSMAN SHEIKH
Credential	:
Telephone Number	:	952-652-7553

Provider Enumeration Date	:	12/29/2023
Last Update Date	:	12/29/2023

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