Minneosta Wellness Center LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

1083995-1-HCBS Issued in MN

Legal business name

MINNEOSTA WELLNESS CENTER LLC

Practice address

808 Berry St Apt 192
Saint Paul, MN 55114-1082

Phone

(612) 618-5841

Fax

(651) 646-0950

NPI assigned

Jan 2, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Ubah Abubaker Shirwa

Title

Owner

Phone

(612) 618-5841

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483315200000",
    "number": "1821533779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 BERRY ST APT 192",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141082",
            "telephone_number": "612-618-5841",
            "fax_number": "651-646-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 BERRY ST APT 192",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141082",
            "telephone_number": "612-618-5841",
            "fax_number": "651-646-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNEOSTA WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-02",
        "last_updated": "2017-01-02",
        "status": "A",
        "authorized_official_last_name": "SHIRWA",
        "authorized_official_first_name": "UBAH",
        "authorized_official_middle_name": "ABUBAKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-618-5841",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1083995-1-HCBS",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MN",
            "license": "1083995-1-HCBS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Point of Service in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; 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.