KIDS SPACE LLC NPI 1063105724

NPI Details

KIDS SPACE LLC is a community behavioral health in Spring Lake Park, MN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. KIDS SPACE LLC NPI is 1063105724. The provider is registered as an organization entity type.

The provider's business location address is:

1440 85TH AVE NE UNIT D
SPRING LAKE PARK, MN
ZIP 55432-323
Phone: (612) 800-4509

The provider's authorized official is Abdusamed M. Hassen .
The authorized official title is Owner and has the following contact phone number (612) 800-4509.

The enumeration date for this NPI number is 5/30/2023 and was last updated on 5/30/2023.

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: