Provider Demographics
NPI:1073077459
Name:TWIN CITIES THERAPY SERVICES
Entity Type:Organization
Organization Name:TWIN CITIES THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMATER
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-236-7411
Mailing Address - Street 1:327 MARSCHALL RD STE 395
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1680
Mailing Address - Country:US
Mailing Address - Phone:612-806-1403
Mailing Address - Fax:
Practice Address - Street 1:327 MARSCHALL RD STE 395
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1680
Practice Address - Country:US
Practice Address - Phone:612-806-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder