Prime Health Wellness LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

PRIME HEALTH WELLNESS LLC

Practice address

1405 Lilac Dr N Ste 251a
Minneapolis, MN 55422-4535

Phone

(763) 344-6351

NPI assigned

Sep 12, 2024

Organization subpart

No

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

Authorized official

Name

Mohad Liban JamaNPI 1336872712

Title

President

Phone

(612) 919-1424

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mohad Jama

  • Behavior Technician
  • Saint Paul, MN
  • NPI 1336872712
  NPD Authorized official

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1477389633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 251A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 LILAC DR N STE 251A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554224535",
            "telephone_number": "763-344-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-10-01",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "JAMA",
        "authorized_official_first_name": "MOHAD",
        "authorized_official_middle_name": "LIBAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-919-1424"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Autism Center Inc
• Prime Growth Behavior Services Inc.
• Prime Healing Inc
• Prime Health Professional Corporation
• Prime Health Services Inc
• Prime Medical Centers LLC
• Prime Meridian, Inc.
• Prime Steps Inc
• Primecare Midwest LLC
• Primemed PLLC

• Adult Mental Health Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.