1598817678 NPI number — CITY OF MINNEAPOLIS

Table of content: (NPI 1598817678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598817678 NPI number — CITY OF MINNEAPOLIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF MINNEAPOLIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MINNEAPOLIS DEPARTMENT OF HEALTH AND FAMILY SUPPORT SCHOOL BASED CLINI
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598817678
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 4TH AVE S RM 520
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55415-1345
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-673-2301
Provider Business Mailing Address Fax Number:
612-673-3866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3131 19TH AVENUE SOUTH
Provider Second Line Business Practice Location Address:
ROOM 122
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-668-4333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KYLE
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
SBC MANAGER
Authorized Official Telephone Number:
612-673-5305

Provider Taxonomy Codes

  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QS1000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)