Provider Demographics
NPI:1972363307
Name:TWIN CITIES RESTORATIVE HEALTH LLC
Entity type:Organization
Organization Name:TWIN CITIES RESTORATIVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROUMAN
Authorized Official - Middle Name:OSMAN
Authorized Official - Last Name:ILMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-895-0199
Mailing Address - Street 1:3845 HIAWATHA AVE APT 438
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-4452
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2112 ELLIOT AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-6612
Practice Address - Country:US
Practice Address - Phone:612-895-0199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare