| Minneosta Wellness Center Llc | |
|
808 Berry St Apt 192 Saint Paul MN 55114-1082 | |
| (612) 618-5841 | |
| (651) 646-0950 |
| Full Name | Minneosta Wellness Center Llc |
|---|---|
| Speciality | Point Of Service |
| Location | 808 Berry St Apt 192, Saint Paul, Minnesota |
| Authorized Official Name and Position | Ubah Abubaker Shirwa (OWNER) |
| Authorized Official Contact | 6126185841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minneosta Wellness Center Llc 808 Berry St Apt 192 Saint Paul MN 55114-1082 Ph: (612) 618-5841 | Minneosta Wellness Center Llc 808 Berry St Apt 192 Saint Paul MN 55114-1082 Ph: (612) 618-5841 |
| NPI Number | 1821533779 |
|---|---|
| Provider Enumeration Date | 01/02/2017 |
| Last Update Date | 01/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821533779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1083995-1-HCBS (Minnesota) | Secondary |
| 305S00000X | Point Of Service | 1083995-1-HCBS (Minnesota) | Primary |
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