PROVISIONAL HEALTH AND REHABILITATIVE SERVICES LLC
NPI 1841966116
Clinic/Center in Columbia Heights, MN

Q: What is Provisional Health And Rehabilitative Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since August 18, 2021

4111 CENTRAL AVE NE STE 208B, COLUMBIA HEIGHTS, MN 55421(763) 205-3258 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Provisional Health And Rehabilitative Services Llc NPPES

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

PROVISIONAL HEALTH AND REHABILITATIVE SERVICES LLC (NPI 1841966116) is a healthcare organization registered as a clinic/center in Columbia Heights, Minnesota and active in the NPI registry since August 2021. The organization lists Ali Jama, Owner, as its authorized official.

NPPES Registry Identity

NPI1841966116

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NamePROVISIONAL HEALTH AND REHABILITATIVE SERVICES LLC

Location Address4111 CENTRAL AVE NE STE 208BColumbia Heights, MN 55421-2955

Mailing Address4111 Central Ave Ne Ste 208bColumbia Heights, MN 55421-2955

Phone(763) 205-3258

Organization SubpartNo

Authorized OfficialAli JamaOwner · (952) 687-9064

Enumeration DateAugust 18, 2021

Last NPPES UpdateFebruary 12, 2026

NPPES CertifiedFebruary 12, 2026

✔ NPI 1841966116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

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).

4111 CENTRAL AVE NE STE 208B, Columbia Heights, MN 55421

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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 Provisional Health And Rehabilitative Services LLC's NPI number?

The NPI number for Provisional Health And Rehabilitative Services LLC is 1841966116. It was assigned to this organization in the NPPES registry on August 18, 2021.

Where is Provisional Health And Rehabilitative Services LLC located?

Provisional Health And Rehabilitative Services LLC is located at 4111 Central Ave NE Ste 208B, Columbia Heights, MN 55421. The listed phone number is (763) 205-3258.

What is Provisional Health And Rehabilitative Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Provisional Health And Rehabilitative Services LLC was last updated on February 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.