Organization · Type 2 NPI

Provisional Health and Rehabilitative Services LLC

Clinic/Center · Columbia Heights, MN

NPI number 1841966116 Active

Practice location

4111 Central Ave NE Ste 208B
Columbia Heights, MN 55421-2955

Call (763) 205-3258 Map

Specialties and licenses

TaxonomyCodeLicense
Clinic/Center Primary 261Q00000XNone listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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About NPI 1841966116

Provisional Health and Rehabilitative Services LLC's National Provider Identifier is 1841966116, issued on Aug 18, 2021. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Columbia Heights, MN. The record was last updated on Feb 12, 2026.