Provider Demographics
NPI:1477358885
Name:ABLE MINDS SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:ABLE MINDS SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AYUB
Authorized Official - Middle Name:ABDIRAHMAN
Authorized Official - Last Name:OMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-321-8438
Mailing Address - Street 1:11032 ZEST ST NE UNIT G
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-7489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11032 ZEST ST NE UNIT G
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-7489
Practice Address - Country:US
Practice Address - Phone:612-559-6045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health