# SOUTHDALE THERAPY CENTER LLC

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

## Provider details

- **NPI number:** 1891597233
- **Authorized official:** YAHYE A MOHAMED (ORGANIZER)
- **Authorized official phone:** (612) 479-0327

## Contact information

- **Practice address:** 7101 YORK AVE S STE 250, MINNEAPOLIS, MN 55435-4509
- **Practice address phone:** (612) 479-0327
- **Mailing address:** 7101 YORK AVE S STE 250, MINNEAPOLIS, MN 55435-4509
- **Mailing address phone:** (763) 898-8280

## Taxonomy

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

## Other

- **Enumeration date:** 03/26/2025
- **Last updated:** 03/26/2025