Organization
MAVERICK MENTAL HEALTH LLC
Active
Organization
MAVERICK MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAKTAL ABDIFATAH MOHAMED (OWNER)
(612) 310-2537
Entity
Organization
Contact information
Practice address
9900 13TH AVE N STE 210, PLYMOUTH, MN 55441-5068
(612) 310-2537
Mailing address
9900 13TH AVE N STE 210, PLYMOUTH, MN 55441-5068
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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