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DUNGARVIN MINNESOTA LLC NPI 1235122003


NPI Information

NPI: 1235122003
Provider Name: DUNGARVIN MINNESOTA LLC

Other Name: DUNGARVIN MINNESOTA HOME HEALTH CARE

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 24D2069387

Address:
1440 NORTHLAND DR STE 100
MENDOTA HEIGHTS, MN
ZIP 55120
Phone: (651) 699-6050
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DUNGARVIN MINNESOTA LLC is a community behavioral health in Mendota Heights, MN. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. DUNGARVIN MINNESOTA LLC NPI is 1235122003. The provider is registered as an organization entity type.
The provider Other Name Is Dungarvin Minnesota Home Health Care.

The provider's business location address is:

1440 NORTHLAND DR STE 100
MENDOTA HEIGHTS, MN
ZIP 55120-028
Phone: (651) 699-6050
Fax: (651) 699-7265

The provider's authorized official is Lori Kress .
The authorized official title is Ceo and has the following contact phone number (651) 699-0206.

The CLIA number assigned to this NPI record is 24D2069387 - other - supervised lvg facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/26/2005 and was last updated on 4/26/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
124-8106OTHERMINNESOTACMS CERTIFICATION NUMBER (CCN)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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