Provider Demographics
NPI:1003639113
Name:NAATH CARE LLC
Entity type:Organization
Organization Name:NAATH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ITANG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:507-923-7858
Mailing Address - Street 1:2000 LYNDALE AVE S UNIT 621
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-3759
Mailing Address - Country:US
Mailing Address - Phone:507-923-7858
Mailing Address - Fax:
Practice Address - Street 1:2000 LYNDALE AVE S UNIT 621
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-3759
Practice Address - Country:US
Practice Address - Phone:507-923-7858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty