Spark Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SPARK RECOVERY LLC

Practice address

2375 University Ave W Ste 200
Saint Paul, MN 55114-1678

Phone

(612) 702-9499

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Hanad Yussuf Mohamed

Title

Owner

Phone

(612) 702-9499

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1881316461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 UNIVERSITY AVE W STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 UNIVERSITY AVE W STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141678",
            "telephone_number": "612-702-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "HANAD",
        "authorized_official_middle_name": "YUSSUF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-702-9499"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmalee T Spahl
• Terrance J Spahl, D.D.S.
• David Andrew Spande, O.D.
• Stephanie Ann Spandl, LICSW
• Krista Spanier
• Sparks Psychiatry PLLC
• Jack Sparks
• Jennifer May Sparrow, PHARMD
• Jessica Spatenka
• Speakrightnow, LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.