NPI 1114763372
Spark Behavioral Health
Practice location
- Address
- 12751 County Road 5 STE 109, Burnsville, MN 55337-2275
- Phone
- (952) 213-9989
Authorised official
- Name
- Mohamed a Mohamed
- Title
- Authorized Agent
- Phone
- (952) 213-9989
Registered specialties
Early Intervention Provider Agency
Primary
Registry record
- NPI
- 1114763372
- Entity type
- Organization
- NPI issued
- 6 Jul 2024
- Record last updated
- 6 Jul 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.