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NPI Code Detail

MEDICARE: ALLIED HEALING CENTER INC

MEDICARE: ALLIED HEALING CENTER INC
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
1252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1386283737
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLIED HEALING CENTER INC
Provider Business Mailing Address
First Line : 2104 PARK AVE STE 102D
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-6607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2104 PARK AVE STE 102D
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-6607
Country : US
Telephone Number : 773-681-4276
Fax Number : 612-444-8956
Authorized Official
Title or Position : OWNER/MANAGER
Name : ABDIKHALIQ JIBRIL
Credential :
Telephone Number : 773-681-4276
Provider Enumeration Date : 01/02/2020
Last Update Date : 01/02/2020

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Directions to “ALLIED HEALING CENTER INC ” Practice Location

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