Organization
STAR THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOUKTAR BOURALEH (OWNER/MANAGER)
(770) 713-7467
Entity
Organization
Contact information
Practice address
4470 W 78TH STREET CIR, BLOOMINGTON, MN 55435-5408
(770) 713-7467
Mailing address
8200 HUMBOLDT AVE S # 402, BLOOMINGTON, MN 55431-1433
(770) 713-7467
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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