Organization
APPLIED BEHAVIORAL THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARMARKE ALRISAK ELMI (OWNER)
(612) 518-8176
Entity
Organization
Contact information
Practice address
2006 PORTLAND AVE APT 356, MINNEAPOLIS, MN 55404-2884
(612) 518-8176
Mailing address
2006 PORTLAND AVE APT 356, MINNEAPOLIS, MN 55404-2884
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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