Provider Demographics
NPI:1326406570
Name:BHAKTI OCCUPATIONAL THERAPY LLC
Entity type:Organization
Organization Name:BHAKTI OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUSKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-524-9237
Mailing Address - Street 1:7550 FRANCE AVE S
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5624
Mailing Address - Country:US
Mailing Address - Phone:612-859-7709
Mailing Address - Fax:
Practice Address - Street 1:7550 FRANCE AVE S
Practice Address - Street 2:SUITE 220
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5624
Practice Address - Country:US
Practice Address - Phone:612-859-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty