Spark Behavioral Health
NPI #1114763372 in Burnsville, Minnesota
Provider Information
- NPI Number
- 1114763372
- Entity Type
- Organization
- Organization Name
- Spark Behavioral Health
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Jul 6, 2024
- Last Updated
- Jul 6, 2024
Practice Location
- Address
- 12751 COUNTY ROAD 5 STE 109
- City
- Burnsville
- State
- Minnesota
- ZIP Code
- 55337-2275
- Phone
- (952) 213-9989
Authorized Official
- Name
- MOHAMED A MOHAMED
- Title
- AUTHORIZED AGENT
- Phone
- (952) 213-9989
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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