NPI 1053143479

Angel Center LLC

Organisation Early Intervention Provider Agency Fridley, MN

Practice location

Address: 7260 University Ave NE STE 315, Fridley, MN 55432-3129
Phone: (763) 898-8368
Mailing address: 12648 Leyte St NE, Blaine, MN 55449-6791

Authorised official

Name: Anhar Badri Ibrahim
Title: Owner
Phone: (763) 898-8368

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

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Registry record

NPI: 1053143479
Entity type: Organization
NPI issued: 15 Aug 2024
Record last updated: 15 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.