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VILLAGE SUPPORT THERAPY AND CONSULTING LLC NPI 1356964332


NPI Information

NPI: 1356964332
Provider Name: VILLAGE SUPPORT THERAPY AND CONSULTING LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
5424 FREMONT AVE N
BROOKLYN CENTER, MN
ZIP 55430
Phone: (612) 223-0099
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VILLAGE SUPPORT THERAPY AND CONSULTING LLC is a mental health (including community mental health center) clinic center in Brooklyn Center, MN. VILLAGE SUPPORT THERAPY AND CONSULTING LLC NPI is 1356964332. The provider is registered as an organization entity type.

The provider's business location address is:

5424 FREMONT AVE N
BROOKLYN CENTER, MN
ZIP 55430-160
Phone: (612) 223-0099

The provider's authorized official is Ebony Eromobor .
The authorized official title is Owner/founder and has the following contact phone number (612) 223-0099.

The enumeration date for this NPI number is 5/25/2020 and was last updated on 5/25/2020.


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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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: 5/5/2024

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