Provider Demographics
NPI:1558079608
Name:CONSCIOUS HEALING CENTER
Entity Type:Organization
Organization Name:CONSCIOUS HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:MUHAMUD
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-440-2564
Mailing Address - Street 1:7270 UPPER 157TH ST W
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5125
Mailing Address - Country:US
Mailing Address - Phone:651-440-2564
Mailing Address - Fax:
Practice Address - Street 1:7270 UPPER 157TH ST W
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5125
Practice Address - Country:US
Practice Address - Phone:651-440-2564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health