Provider Demographics
NPI:1962168914
Name:PARTNERS IN CHILD DEVELOPMENT
Entity type:Organization
Organization Name:PARTNERS IN CHILD DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YASIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-889-1987
Mailing Address - Street 1:275 4TH ST E STE 635
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1653
Mailing Address - Country:US
Mailing Address - Phone:612-889-1987
Mailing Address - Fax:612-208-0184
Practice Address - Street 1:275 4TH ST E STE 635
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1653
Practice Address - Country:US
Practice Address - Phone:612-889-1987
Practice Address - Fax:612-208-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health