1639408172 NPI number — AVENUE FOR HOME CARE, INC

Table of content: MR. BRIAN STEVEN ARKELIAN LCSW (NPI 1770643546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639408172 NPI number — AVENUE FOR HOME CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AVENUE FOR HOME CARE, INC
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:
Provider Other Organization Name Type Code:
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:
1639408172
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7000 57TH AVE N
Provider Second Line Business Mailing Address:
STE 120
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55428-3369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-537-6104
Provider Business Mailing Address Fax Number:
763-537-7514

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 57TH AVE N
Provider Second Line Business Practice Location Address:
STE 120
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55428-3369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-537-6104
Provider Business Practice Location Address Fax Number:
763-537-7514
Provider Enumeration Date:
12/11/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OKITIKPI
Authorized Official First Name:
OCHUKO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
763-537-6104

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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