Provider Demographics
NPI:1427897966
Name:CORE HEALTH SERVICE INC
Entity type:Organization
Organization Name:CORE HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YASIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KODAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-987-1120
Mailing Address - Street 1:8609 LYNDALE AVE S STE 205A
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-2745
Mailing Address - Country:US
Mailing Address - Phone:612-429-3111
Mailing Address - Fax:952-439-3999
Practice Address - Street 1:8609 LYNDALE AVE S STE 205A
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-2745
Practice Address - Country:US
Practice Address - Phone:612-429-3111
Practice Address - Fax:952-439-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty