Provider Demographics
NPI:1932733284
Name:UBBAD LLC
Entity Type:Organization
Organization Name:UBBAD LLC
Other - Org Name:UBBAD BEHAVIORAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-876-6681
Mailing Address - Street 1:4111 CENTRAL AVE NE STE 205
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2956
Mailing Address - Country:US
Mailing Address - Phone:612-876-6681
Mailing Address - Fax:
Practice Address - Street 1:50 28TH AVE N STE 50
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4241
Practice Address - Country:US
Practice Address - Phone:612-876-6681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty