Affinity Therapy Services

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

AFFINITY THERAPY SERVICES

Practice address

5245 Edina Industrial Blvd
Edina, MN 55439-2910

Phone

(612) 227-0875

NPI assigned

Nov 2, 2021

Last updated

Nov 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abdirahman Shire

Title

President

Phone

(612) 227-0875

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1760147045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 EDINA INDUSTRIAL BLVD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392910",
            "telephone_number": "612-227-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 EDINA INDUSTRIAL BLVD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392910",
            "telephone_number": "612-227-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "SHIRE",
        "authorized_official_first_name": "ABDIRAHMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-227-0875"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Edina, MN
• Providers in Edina, MN by specialty
• Adolescent and Children Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.