Mindful Recovery Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MINDFUL RECOVERY SERVICES LLC

Practice address

151 Silver Lake Rd NW Unit 6
New Brighton, MN 55112-8101

Phone

(612) 261-9312

NPI assigned

Mar 5, 2024

Last updated

Mar 5, 2024By 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

Abdirizak Ali IsmailNPI 1710789219

Title

Owner

Phone

(612) 261-9312

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, and the practitioner matching its NPPES authorized official.

• Abdirizak Ali Ismail

  • Behavior Technician
  • Eden Prairie, MN
  • NPI 1710789219
  Authorized official Same address or phone

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1811754831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SILVER LAKE RD NW UNIT 6",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551128101",
            "telephone_number": "612-261-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 SILVER LAKE RD NW UNIT 6",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551128101",
            "telephone_number": "612-261-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "ISMAIL",
        "authorized_official_first_name": "ABDIRIZAK",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-261-9312"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Frederick Micka, MD
• Mike Marek Counseling LLC
• Mia Mikel, L.A.D.C.
• William Miller, D.C.
• Mina Medical Clinic LLC
• Minn Care Home Health
• Minnesota Vascular Surgery Center
• Leonard Moeller, LAMFT
• Hodan Abdinasir Mohamed
• Maria Mohamed

• Clinic/Center in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.