Provider Demographics
NPI:1033888391
Name:INOVA CARE SERVICES LLC
Entity Type:Organization
Organization Name:INOVA CARE SERVICES LLC
Other - Org Name:INOVA CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOREYA
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-703-8828
Mailing Address - Street 1:1710 DOUGLAS DR N STE 226X
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4371
Mailing Address - Country:US
Mailing Address - Phone:612-703-8828
Mailing Address - Fax:952-658-0434
Practice Address - Street 1:1710 DOUGLAS DR N STE 226X
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4371
Practice Address - Country:US
Practice Address - Phone:612-703-8828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty