Provider Demographics
NPI:1356957823
Name:TWINCITIES THERAPY CENTER INC
Entity type:Organization
Organization Name:TWINCITIES THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOWZAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-297-7690
Mailing Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2915
Mailing Address - Country:US
Mailing Address - Phone:952-297-7690
Mailing Address - Fax:612-886-2618
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2915
Practice Address - Country:US
Practice Address - Phone:952-297-7690
Practice Address - Fax:612-886-2618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health