TBI RESIDENTIAL AND COMMUNITY SERVICES INC. NPI 1639772684

NPI Information

NPI: 1639772684
Provider Name: TBI RESIDENTIAL AND COMMUNITY SERVICES, INC.
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
114 SOUTH 20TH AVENUE WEST, SUITE B
DULUTH, MN
ZIP 55806
Phone: (218) 733-1331
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TBI RESIDENTIAL AND COMMUNITY SERVICES, INC. is an adult day care clinic center in Duluth, MN. TBI RESIDENTIAL AND COMMUNITY SERVICES, INC. NPI is 1639772684. The provider is registered as an organization entity type.

The provider's business location address is:

114 SOUTH 20TH AVENUE WEST, SUITE B
DULUTH, MN
ZIP 55806-526
Phone: (218) 733-1331
Fax: (952) 922-6885

The provider's authorized official is Lisa M Thelen .
The authorized official title is Executive Director and has the following contact phone number (952) 563-2222.

The enumeration date for this NPI number is 11/20/2020 and was last updated on 11/24/2020.

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
1	261QA0600X	Clinic/Center	Adult Day Care			Yes

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
1	1072277	MEDICAID	MINNESOTA

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: 11/14/2023

NPI Synchronization or Removal

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