GREATER MINNEAPOLIS CRISIS NURSERY - NPI NUMBER 1427308360

Summary

Provider Name: GREATER MINNEAPOLIS CRISIS NURSERY

NPI Number: 1427308360

Clasification: Community/Behavioral Health (251S00000X)

Address:
5400 GLENWOOD AVE
GOLDEN VALLEY, MN
ZIP 55422

Phone Number: (763) 591-0400



Detailed Information

GREATER MINNEAPOLIS CRISIS NURSERY is a community/behavioral health in Golden Valley, MN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. The assigned NPI number for this provider is 1427308360 and is registered as an organization entity type.

The provider's business address is:

5400 GLENWOOD AVE
GOLDEN VALLEY, MN
ZIP 55422-120
Phone: (763) 591-0400
Fax: (763) 591-0700

The provider's authorized official is Molly Kenney .
The authorized official title is Program Director and has the following contact phone number (796) 559-2065.

The enumeration date for this NPI number is 9/19/2012 and was last updated on 9/19/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251S00000X Community/Behavioral Health Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1427308360 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name GREATER MINNEAPOLIS CRISIS NURSERY The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 5400 GLENWOOD AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name GOLDEN VALLEY The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name MN The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 554225120 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 7635910400 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 7635910700 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 9/19/2012 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 9/19/2012 The date that a record was last updated or changed.
14 Authorized Official Last Name KENNEY The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name MOLLY The first name of the authorized official.
16 Authorized Official Title or Position PROGRAM DIRECTOR The title or position of the authorized official.
17 Authorized Official Telephone Number 7965592065 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 251S00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Authorized Official Credential Text LICSW

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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