NPI 1255943361

Intergalactic Therapy Centre LLC

Organisation Early Intervention Provider Agency Eagan, MN

Practice location

Address: 860 Blue Gentian Rd STE 200, Eagan, MN 55121-1567
Phone: (612) 458-8723
Fax: (612) 455-2185

Authorised official

Name: Garad Hagi Mohamed
Title: Owner
Phone: (612) 458-8723

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

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Registry record

NPI: 1255943361
Entity type: Organization
NPI issued: 19 Aug 2020
Record last updated: 18 Sep 2020

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.