# GREEN HAVEN IRTS LLC

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

## Provider details

- **NPI number:** 1598589038
- **Authorized official:** MOHAMOUD EGAL (CEO)
- **Authorized official phone:** (651) 347-1747

## Contact information

- **Practice address:** 513 WOOD WAY, BURNSVILLE, MN 55337-5732
- **Practice address phone:** (763) 485-1011
- **Mailing address:** 1500 MCANDREWS RD W STE 203, BURNSVILLE, MN 55337-4445
- **Mailing address phone:** (763) 485-1011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 283Q00000X | Psychiatric Hospital | — | NULL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/12/2024
- **Last updated:** 03/05/2025