Organization
INTERGALACTIC THERAPY CENTRE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARAD HAGI MOHAMED SR. (OWNER)
(612) 458-8723
Entity
Organization
Contact information
Practice address
860 BLUE GENTIAN RD STE 200, EAGAN, MN 55121-1567
(612) 458-8723
(612) 455-2185
Mailing address
860 BLUE GENTIAN RD STE 200, EAGAN, MN 55121-1567
(612) 458-8723
(612) 455-2185
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
09/18/2020
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