| Brightline Wellness Llc | |
|
19933 Itea Ave Lakeville MN 55044-5032 | |
| (612) 290-4698 | |
| Not Available |
| Full Name | Brightline Wellness Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 19933 Itea Ave, Lakeville, Minnesota |
| Authorized Official Name and Position | Fadxi Cabdi (OWNER) |
| Authorized Official Contact | 6825539305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightline Wellness Llc 3809 42nd Ave S Minneapolis MN 55406-3503 Ph: () - | Brightline Wellness Llc 19933 Itea Ave Lakeville MN 55044-5032 Ph: (612) 290-4698 |
| NPI Number | 1518774173 |
|---|---|
| Provider Enumeration Date | 12/16/2024 |
| Last Update Date | 12/16/2024 |
| Certification Date | 12/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518774173 | NPI | - | NPPES |
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