Provider Demographics
NPI:1821241761
Name:UNBOUND THERAPY RESOURCES
Entity Type:Organization
Organization Name:UNBOUND THERAPY RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RESMAA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENAKEM
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LICSW
Authorized Official - Phone:612-810-2605
Mailing Address - Street 1:1101 HUMBOLDT AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-4011
Mailing Address - Country:US
Mailing Address - Phone:612-810-2605
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD STE 413
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2326
Practice Address - Country:US
Practice Address - Phone:612-810-2605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health