CRYSTAL WELLNESS CENTER LLC NPI 1194359547

NPI Information

NPI: 1194359547
Provider Name: CRYSTAL WELLNESS CENTER LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
9001 E BLOOMINGTON FWY STE 147
BLOOMINGTON, MN
ZIP 55420
Phone: (952) 658-6845
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CRYSTAL WELLNESS CENTER LLC is an adult mental health clinic center in Bloomington, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. CRYSTAL WELLNESS CENTER LLC NPI is 1194359547. The provider is registered as an organization entity type.

The provider's business location address is:

9001 E BLOOMINGTON FWY STE 147
BLOOMINGTON, MN
ZIP 55420-450
Phone: (952) 658-6845

The provider's authorized official is Mohamed Abdiqani Nur .
The authorized official title is Owner/administrator and has the following contact phone number (952) 658-6845.

The enumeration date for this NPI number is 2/25/2020 and was last updated on 12/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261Q00000X	Clinic/Center		No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
3	261QM0850X	Clinic/Center	Adult Mental Health	Yes
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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