Provider Demographics
NPI:1801630546
Name:AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:AIM PSYCHIATRIC MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:651-299-6187
Mailing Address - Street 1:8400 NORMANDALE LAKE BLVD., SUITE 920-#93
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:651-299-6187
Mailing Address - Fax:651-666-1619
Practice Address - Street 1:8400 NORMANDALE LAKE BLVD STE 920
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3843
Practice Address - Country:US
Practice Address - Phone:651-299-6187
Practice Address - Fax:651-666-1619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty