Dungarvin Oklahoma Llc in Mendota Heights - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Dungarvin Oklahoma Llc - NPI 1083789754
Dungarvin Oklahoma Llc is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Mendota Heights, Minnesota. Dungarvin Oklahoma Llc practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Dungarvin Oklahoma Llc is 1083789754. The last update date is 2023-04-27.
Dungarvin Oklahoma Llc's current location address is 1444 Northland Dr Ste 200, Mendota Heights, Minnesota. You can contact this provider via phone number 6516990206 and fax number 6516990799. The mailing address for Dungarvin Oklahoma Llc is 1444 Northland Dr Ste 200, Mendota Heights, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dungarvin Oklahoma Llc |
|---|---|
| Address | 1444 Northland Dr Ste 200, Mendota Heights, Minnesota |
| Phone Number | 6516990206 |
| Fax Number | 6516990799 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Kress Lori |
| Telephone Number | 6516990206 |
NPI Number Detail
| NPI Number | 1083789754 |
|---|---|
| Provider Enumeration Date | 2006-11-21 |
| Last Updated Date | 2023-04-27 |
Provider Mailing Address Detail
| Address | 1444 Northland Dr Ste 200 |
|---|---|
| City | Mendota Heights |
| State | Minnesota (MN) |
| Post Code | 551201032 |
| Phone Number | 6516990206 |
| Fax Number | 6516990799 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 100631340G |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100631340G | OK | OHCA PROVIDER ID |
Post Comment/ Review Below
What is the Dungarvin Oklahoma Llc's 1083789754?
The Dungarvin Oklahoma Llc's NPI (National Provider Identifier) Number is 1083789754. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Dungarvin Oklahoma Llc is geographically located?
The Dungarvin Oklahoma Llc is physically situated at the following location: 1444 Northland Dr Ste 200, Mendota Heights, MN, 551201032.
What is Dungarvin Oklahoma Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Dungarvin Oklahoma Llc's area of specialization is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 320900000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1083789754 to Dungarvin Oklahoma Llc?
The Centers for Medicare & Medicaid Services assigned the 1083789754 to Dungarvin Oklahoma Llc on 2006-11-21.
As of what date were the Dungarvin Oklahoma Llc's details last updated?
The information pertaining to the Dungarvin Oklahoma Llc, including its address, specialty, and other details, was most recently updated on 2023-04-27.