| Omnipotent Youth Society L.l.c. | |
|
426 Irene Ct Roseville MN 55113-3520 | |
| (612) 559-2160 | |
| Not Available |
| Full Name | Omnipotent Youth Society L.l.c. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 426 Irene Ct, Roseville, Minnesota |
| Authorized Official Name and Position | Jingming N/a Wang (OWNER) |
| Authorized Official Contact | 6125592160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omnipotent Youth Society L.l.c. 426 Irene Ct Roseville MN 55113-3520 Ph: (612) 559-2160 | Omnipotent Youth Society L.l.c. 426 Irene Ct Roseville MN 55113-3520 Ph: (612) 559-2160 |
| NPI Number | 1679345904 |
|---|---|
| Provider Enumeration Date | 10/30/2023 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679345904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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