Bridge To Brilliance Therapy Llc

LBN: Bridge To Brilliance Therapy Llc
Bridge To Brilliance Therapy Llc is an health care organization with primary practice located at 13740 Nicollet Ave , Burnsville MN 55337-4003. The organization recently has only one registered license in Agencies / Early Intervention Provider Agency, which is considered as the primary health care specialty. Bridge To Brilliance Therapy Llc can be contacted via phone (612) 987-3455, or through Ahmed, Anisa Mohamed via phone (612) 987-3455.

Contact Information

Primary practice address
13740 Nicollet Ave Burnsville MN 55337-4003
Phone: (612) 987-3455
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ahmed, Anisa Mohamed
Phone: (612) 987-3455

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X

Profile Details

NPI number 1114707700
LBN Legal business name Bridge To Brilliance Therapy Llc
DBA Doing business as
Authorized official Ahmed, Anisa Mohamed
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2023
Last updated Oct 2nd, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114707700 NPPES
Minnesota MEDICAID 1093450918

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