Abdullahi Hassan Abdirisak

Individual provider Active NPI Behavior Technician · Saint Louis Park, MN

NPI 1326822016 · NPPES record last updated Aug 23, 2023

Key facts

NPI
1326822016
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4236 Park Glen Rd
Saint Louis Park, MN 55416-4758
Phone
(952) 888-7055
NPI assigned
Aug 23, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Home Healthcare L. L. C. Current Accepting new patients
Iska Inc Past
since Sep 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MN Yes

Addresses

Primary practice location

4236 Park Glen Rd
Saint Louis Park, MN 55416-4758

Mailing address

4236 Park Glen Rd
Saint Louis Park, MN 55416-4758
Phone (952) 888-7055

Other providers in Saint Louis Park, MN

All providers in Saint Louis Park, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.