Provider Demographics
NPI:1255989489
Name:HEALTH INNOVATIONS OF AMERICA
Entity type:Organization
Organization Name:HEALTH INNOVATIONS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AL RIYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-822-7464
Mailing Address - Street 1:4525 W 36 1/2 ST APT 52
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD STE 427
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2359
Practice Address - Country:US
Practice Address - Phone:866-822-7464
Practice Address - Fax:952-426-0752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)