LAVISH DIVINE SERVICES INC. NPI 1588308639

NPI Information

NPI: 1588308639
Provider Name: LAVISH DIVINE SERVICES INC.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
7204 W 27TH ST STE 213
ST LOUIS PARK, MN
ZIP 55426
Phone: (952) 297-2348
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LAVISH DIVINE SERVICES INC. is an adult mental health clinic center in St Louis Park, 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. LAVISH DIVINE SERVICES INC. NPI is 1588308639. The provider is registered as an organization entity type.

The provider's business location address is:

7204 W 27TH ST STE 213
ST LOUIS PARK, MN
ZIP 55426-113
Phone: (952) 297-2348
Fax: (651) 780-7085

The provider's authorized official is Fardosa Hassan .
The authorized official title is Owner and has the following contact phone number (952) 297-2348.

The enumeration date for this NPI number is 4/25/2022 and was last updated on 4/25/2022.

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	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

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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