Simmons, Samuel
Simmons, Samuel is an sole proprietor health care provider with primary practice located at 3442 25Th Ave S , Minneapolis MN 55406-2504. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Simmons, Samuel can be contacted via phone (612) 721-0106.Contact Information
Primary practice address
3442 25Th Ave S
Minneapolis MN 55406-2504
Phone: (612) 721-0106
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 300322 | Minnesota |
Profile Details
| NPI number | 1902281256 |
|---|---|
| LBN Legal business name | Simmons, Samuel |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2015 |
| Last updated | Jul 28th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902281256 | NPPES |
| Minnesota | Other | 300322 | LADC |
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