Organization Active NPI

Angel Academy Inc

  • Early Intervention Provider Agency
  • Burnsville, MN
National Provider Identifier
1366052953
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
ANGEL ACADEMY INC
Practice address
2208 E 117TH St
Burnsville, MN 55337-1265
Phone
(612) 447-2381
NPI assigned
Aug 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Lul Mohamed
Title
President
Phone
(612) 447-2381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

2208 E 117TH St
Burnsville, MN 55337-1265

Mailing address

2208 E 117TH St
Burnsville, MN 55337-1265
Phone (612) 447-2381

National Provider Directory

National Provider Directory

Locations

2208 E 117th St
Burnsville, MN 55337
Phone (952) 236-7880

2200 E 117th St
Ste 2208
Burnsville, MN 55337

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1366052953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 E 117TH ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371265",
            "telephone_number": "612-447-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 E 117TH ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371265",
            "telephone_number": "612-447-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL ACADEMY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "LUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-447-2381"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.