1700220613 NPI number — KID TALK INC

Table of content: (NPI 1700220613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700220613 NPI number — KID TALK INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KID TALK 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:
1700220613
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1772 STEIGER LAKE LN STE 100
Provider Second Line Business Mailing Address:
PO BOX 34
Provider Business Mailing Address City Name:
VICTORIA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55386-7723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-443-9888
Provider Business Mailing Address Fax Number:
952-443-9804

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9400 CEDAR LAKE RD S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST LOUIS PARK
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55426-2361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-443-9888
Provider Business Practice Location Address Fax Number:
952-443-9804
Provider Enumeration Date:
04/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ALMQUIST
Authorized Official First Name:
CANDACE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
952-443-9888

Provider Taxonomy Codes

  • Taxonomy code: 225XP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1311578 . This is a "AMERICA'S PPO/CIGNA/ARAZ" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 169036 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 565581028804 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 78B64KI . This is a "BCBS MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 001442700 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 16154051 . This is a "PATIENT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 565581028803 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 017J6KI . This is a "BCBS MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 4600402 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 76842 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com