Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Provisional Health and Rehabilitative Services LLC

Organization Clinic/Center · NPI 1841966116

Provisional Health and Rehabilitative Services LLC is a Clinic/Center in Columbia Heights, Minnesota. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4111 Central Ave NE Ste 208B
Columbia Heights, MN 55421-2955
Phone: (763) 205-3258
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1841966116
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ali Jama — Owner · (952) 687-9064
NPI enumeratedAugust 18, 2021
Last updated in NPPESFebruary 12, 2026
Certification dateFebruary 12, 2026
Mailing address4111 Central Ave Ne Ste 208b, Columbia Heights, MN 55421-2955

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