Provider Demographics
NPI:1437027612
Name:HEALING PATH RECUPERATIVE CARE
Entity type:Organization
Organization Name:HEALING PATH RECUPERATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FOWSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SABTOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-540-8035
Mailing Address - Street 1:1008 42 1/2 AVE NE # 55421
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3159
Mailing Address - Country:US
Mailing Address - Phone:612-540-8035
Mailing Address - Fax:612-540-8035
Practice Address - Street 1:925 30TH AVE S APT 207
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1157
Practice Address - Country:US
Practice Address - Phone:612-394-5624
Practice Address - Fax:612-540-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA323415100OtherUMPI