Diversity Health Service LLC
Clinic/Center, Developmental Disabilities in Bloomington, MN. Organization (NPI-2).
NPI number1164046926
StatusActive
Last updated in NPPESJun 7, 2020
Details
- NPI
- 1164046926
- Entity type
- Organization (NPI-2)
- Legal business name
- Diversity Health Service LLC
- Organization subpart
- No
- Enumeration date
- Jun 7, 2020
- Certification date
- Jun 7, 2020
- Last updated
- Jun 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD1600X | Clinic/Center, Developmental Disabilities | – | – | Yes |
Practice location
7900 International Dr Ste 300Bloomington, MN 55425-2562
Phone 612-834-5913
Mailing address
7900 International Dr Ste 300Bloomington, MN 55425-2562
Phone 612-834-5913
Authorized official
Mohamed Arab
Ceo
6128345913
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