# LOOM WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588557342
- **Authorized official:** HODAN IBRAHIM YUSUF (DIRECTOR/OWNER)
- **Authorized official phone:** (612) 407-1769

## Contact information

- **Practice address:** 1000 E 146TH ST STE 105, BURNSVILLE, MN 55337-4655
- **Practice address phone:** (612) 407-1769
- **Mailing address:** 1000 E 146TH ST STE 105, BURNSVILLE, MN 55337-4655
- **Mailing address phone:** (612) 407-1769

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/30/2025
- **Last updated:** 05/30/2025