Organization
MODERN HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAEL IBRAHIM BUTA (MANAGER)
(763) 445-0332
Entity
Organization
Contact information
Practice address
1490 FROST AVE, MAPLEWOOD, MN 55109-4450
(651) 363-8418
Mailing address
1490 FROST AVE, MAPLEWOOD, MN 55109-4450
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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