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8609 Lyndale Ave S, Suite 213c Bloomigton MN 55420-5542 | |
(952) 777-4625 | |
(952) 777-4627 |
Full Name | |
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Speciality | Early Intervention Provider Agency |
Location | 8609 Lyndale Ave S, Suite 213c, Bloomigton, Minnesota |
Authorized Official Name and Position | Abdisallam A Abdulle (CEO) |
Authorized Official Contact | 9527774625 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8609 Lyndale Ave S Ste 213c Minneapolis MN 55420-2769 Ph: (612) 200-9466 | 8609 Lyndale Ave S, Suite 213c Bloomigton MN 55420-5542 Ph: (952) 777-4625 |
NPI Number | 1124542360 |
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Provider Enumeration Date | 07/31/2017 |
Last Update Date | 07/31/2017 |
Identifier | Type | State | Issuer |
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1124542360 | NPI | - | NPPES |