OrganizationActive
Provisional Health and Rehabilitative Services LLC
NPI 1841966116 · Clinic/Center · Columbia Heights, MN
Provider details
- NPI number
- 1841966116
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ali Jama, Owner(952) 687-9064
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4111 Central Ave Ne Ste 208b
Columbia Heights, MN 55421-2955
Phone: (763) 205-3258
Street-level locationGet directions
Mailing address
4111 Central Ave Ne Ste 208b
Columbia Heights, MN 55421-2955
Registry dates
- Enumerated
- 2021-08-18
- Last updated
- 2026-02-12
- Certified
- 2026-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.