Provider Demographics
NPI:1447841051
Name:MSP SPECIAL LEARNING CENTER
Entity type:Organization
Organization Name:MSP SPECIAL LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FIANANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHUNKAL
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:612-414-7739
Mailing Address - Street 1:2917 15TH AVE S # 100
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1427
Mailing Address - Country:US
Mailing Address - Phone:612-414-7739
Mailing Address - Fax:
Practice Address - Street 1:2917 15TH AVE S # 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1427
Practice Address - Country:US
Practice Address - Phone:612-414-7739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1195253600025OtherMN SOS