1942241344 NPI number — ESSLING'S HOMES PLUS INC

Table of content: (NPI 1942241344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942241344 NPI number — ESSLING'S HOMES PLUS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESSLING'S HOMES PLUS 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:
6
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:
1942241344
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2187 BONNIE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55119-5668
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-735-7259
Provider Business Mailing Address Fax Number:
651-730-1667

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 GERVAIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAPLEWOOD
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55109-2158
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-270-5527
Provider Business Practice Location Address Fax Number:
651-730-1667
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ESSLING CARLSON
Authorized Official First Name:
BRIDGET
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/ DIRECTOR
Authorized Official Telephone Number:
651-270-5527

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  330643 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1978533 . This is a "STATE IDENTIFICTION NUMBE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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