Provider Demographics
NPI:1669260766
Name:TRUE SPECTRUM THERAPY LLC
Entity type:Organization
Organization Name:TRUE SPECTRUM THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-407-0389
Mailing Address - Street 1:2719 W DIVISION ST STE 11
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-3858
Mailing Address - Country:US
Mailing Address - Phone:612-407-0389
Mailing Address - Fax:320-338-8178
Practice Address - Street 1:2719 W DIVISION ST STE 11
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3858
Practice Address - Country:US
Practice Address - Phone:612-407-0389
Practice Address - Fax:320-338-8178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health