| Early Success Therapy Services | |
|
2355 Highway 36 W Ste 479 Roseville MN 55113-3902 | |
| (612) 644-5866 | |
| Not Available |
| Full Name | Early Success Therapy Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2355 Highway 36 W Ste 479, Roseville, Minnesota |
| Authorized Official Name and Position | Suweydo Gale (OWNER) |
| Authorized Official Contact | 6126445866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Early Success Therapy Services 2355 Highway 36 W Ste 479 Roseville MN 55113-3902 Ph: (612) 644-5866 | Early Success Therapy Services 2355 Highway 36 W Ste 479 Roseville MN 55113-3902 Ph: (612) 644-5866 |
| NPI Number | 1952988602 |
|---|---|
| Provider Enumeration Date | 03/27/2021 |
| Last Update Date | 03/27/2021 |
| Certification Date | 03/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952988602 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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