Organization
ENVISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALI MAHAD HUSSEIN (CEO)
(952) 457-3307
Entity
Organization
Contact information
Practice address
860 BLUE GENTIAN RD STE 200, EAGAN, MN 55121-1564
(952) 457-3307
Mailing address
3029 22ND AVE S UNIT 108, MINNEAPOLIS, MN 55407-4023
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/23/2024
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