Provider Demographics
NPI:1699466094
Name:ALTRUISTIC THERAPY LLC
Entity type:Organization
Organization Name:ALTRUISTIC THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-356-7226
Mailing Address - Street 1:3810 BALLANTRAE RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1037
Mailing Address - Country:US
Mailing Address - Phone:952-356-7226
Mailing Address - Fax:
Practice Address - Street 1:3810 BALLANTRAE RD
Practice Address - Street 2:SUITE 311
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1037
Practice Address - Country:US
Practice Address - Phone:952-356-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health