Provider Demographics
NPI:1609618925
Name:MAGNITUDE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:MAGNITUDE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDIRIZAK
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-261-9312
Mailing Address - Street 1:6520 EDENVALE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2564
Mailing Address - Country:US
Mailing Address - Phone:612-261-9312
Mailing Address - Fax:612-500-4700
Practice Address - Street 1:6520 EDENVALE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2564
Practice Address - Country:US
Practice Address - Phone:612-261-9312
Practice Address - Fax:612-500-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency