Organization
PROSPECT HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIINI JAMA (MANAGING PARTNER)
(612) 429-7680
Entity
Organization
Contact information
Practice address
1 W LAKE ST STE 165-3, MINNEAPOLIS, MN 55408-3154
(612) 429-7680
Mailing address
1 W LAKE ST STE 165-3, MINNEAPOLIS, MN 55408-3154
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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