Organization
VITALIA MN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYUB FAARAH (OWNER)
(612) 226-6210
Entity
Organization
Contact information
Practice address
7825 WASHINGTON AVE S STE 615B, MINNEAPOLIS, MN 55439-2430
(612) 226-6210
Mailing address
7825 WASHINGTON AVE S STE 615B, MINNEAPOLIS, MN 55439-2430
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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