Inner Peace Mental Service Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INNER PEACE MENTAL SERVICE INC

Practice address

982 Burr St # a
Saint Paul, MN 55130-3906

Phone

(612) 434-8507

NPI assigned

Jan 10, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anisa Mohamed

Title

Owner

Phone

(612) 434-8507

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1164293965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 BURR ST # A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 BURR ST # A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303906",
            "telephone_number": "612-434-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER PEACE MENTAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ANISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-434-8507"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.