Provider Demographics
NPI:1154082162
Name:BRITTA SVIHEL LLC
Entity Type:Organization
Organization Name:BRITTA SVIHEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SVIHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-203-9068
Mailing Address - Street 1:11292 86TH AVE N STE 105
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4510
Mailing Address - Country:US
Mailing Address - Phone:612-460-0427
Mailing Address - Fax:833-611-0551
Practice Address - Street 1:11292 86TH AVE N STE 105
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4510
Practice Address - Country:US
Practice Address - Phone:612-460-0427
Practice Address - Fax:833-611-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1952787491Medicaid