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PROVISION WELLNESS CENTER LLC
NPI 1427611318
Clinic/Center - Adult Mental Health in St. Anthony, MN

Active since April 17, 2019
4001 STINSON BLVD, SUITE 300, ST. ANTHONY, MN 55421(612) 401-1786 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 2, 2026, Nov 24, 2021, Apr 17, 2019 (3 updates tracked since 2019).

About Provision Wellness Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVISION WELLNESS CENTER LLC (NPI 1427611318) is a healthcare organization registered as an adult mental health in St. Anthony, Minnesota and active in the NPI registry since April 2019. The organization lists Maryan Farah, Owner, as its authorized official.

NPPES Registry Identity

NPI1427611318
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NamePROVISION WELLNESS CENTER LLC
Location Address4001 STINSON BLVD, SUITE 300St. Anthony, MN 55421-3488
Mailing Address4001 Stinson Blvd Ne Ste 300Minneapolis, MN 55421-3424 · (612) 401-1786
Phone(612) 401-1786
Organization SubpartNo
Authorized OfficialMaryan FarahOwner · (612) 401-1786
Enumeration DateApril 17, 2019
Last NPPES UpdateApril 2, 20263 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1427611318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
4001 STINSON BLVD, St. Anthony, MN 55421
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Other Names 1

Doing Business AsProvision Wellness Center Llc

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHAEL EDWARD FORBES DDS
Dentist
4001 STINSON BLVD, SUITE 426
MINNEAPOLIS, MN 55421
Anoka County (612) 788-0751
SCOTT A. ARMSTRONG, D.D.S.
Dentist (General Practice)
4001 STINSON BLVD, SUITE 420
MINNEAPOLIS, MN 55421
Anoka County (612) 788-5151
DR. BIBI NOMO NEUMANN PSY.D.
Counselor
4001 STINSON BLVD, SUITE 223
MINNEAPOLIS, MN 55421
Anoka County (612) 666-3111
AFFINITY MINISTRIES INC.
Social Worker (Clinical)
4001 STINSON BLVD, SUITE 404
MINNEAPOLIS, MN 55421
Anoka County (612) 706-9630
EYE CARE ASSOCIATES PA
Ophthalmology
4001 STINSON BLVD, SUITE 100
MINNEAPOLIS, MN 55421
Anoka County (612) 788-1621
MR. THOMAS LYNN TAUSCHECK DPM
Podiatrist
4001 STINSON BLVD, STE 232
MINNEAPOLIS, MN 55421
Anoka County (612) 788-7274
JAN DIANE JOHNSON MD
Internal Medicine (Critical Care Medicine)
4001 STINSON BLVD, STE 404
MINNEAPOLIS, MN 55421
Anoka County (612) 706-9630
DR. SHOBANA MURALI M.D.
Ophthalmology
4001 STINSON BLVD, SUITE 100
MINNEAPOLIS, MN 55421
Anoka County (612) 788-1621

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provision Wellness Center LLC's NPI number?

The NPI number for Provision Wellness Center LLC is 1427611318. It was assigned to this organization in the NPPES registry on April 17, 2019.

Where is Provision Wellness Center LLC located?

Provision Wellness Center LLC is located at 4001 Stinson Blvd Suite 300, St. Anthony, MN 55421. The listed phone number is (612) 401-1786.

What is Provision Wellness Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Provision Wellness Center LLC was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.