CENTRAL LAKES HEALTH CARE SERVICES LLC (NPI# 1033632740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033632740 |
| Entity Type | Organization |
| Organization Name | CENTRAL LAKES HEALTH CARE SERVICES LLC |
| Other Organization Name | N/A |
| Practice Address |
2355 Highway 36 W Roseville MN 55113-3902 |
| Mailing Address |
2355 Mn-36 410 Roseville MN 55113 |
| Practice Telephone | 7633772418 |
| Mailing Telephone | 7633772418 |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2020-03-01 |
| Authorized Official Name | MR. SHAFI ABDULLE (CEO) |
| Authorized Official Telephone | 6125980652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 382287 | MN | Agencies |
| Other Name | Type Code |
|---|---|
| n/a | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2355 Highway 36 W, Roseville, MN 551133902 | 7633772418 | |
| 9455 Jarrod Ave S, Cottage Grove, MN 55016 | (763) 377-2418 |
| Street Address |
2355 HIGHWAY 36 W |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598209538 | Braincare, LLC | Physiological Laboratory | 2355 Highway 36 W, Ste 400, Roseville, MN 55113-3902 | 2016-12-09 |
| 1366080681 | Rhodaline Aba Takyiwaa Aboagye | Nurse Practitioner | 2355 Highway 36 W, Roseville, MN 55113-3902 | 2019-12-17 |
| 1508306937 | Michelle Rene Beckman | Nurse Practitioner | 2355 Highway 36 W, Roseville, MN 55113-3902 | 2017-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033720024 | Abdiwali H Abdullahi | Home Health | 3110 Old Highway 8 Unit 206, Roseville, MN 55113-1160 | 2020-08-12 |
| 1417574641 | Hero Home Health Care L L C | Home Health | 2275 Snelling Ave N Apt 110, Roseville, MN 55113-4282 | 2020-07-04 |
| 1730719808 | Abundance of Life Adult Family Home, LLC | Home Health | 2355 Highway 36 W Ste 431, Roseville, MN 55113-3902 | 2020-01-17 |
| 1609414564 | Nest Care Services LLC | Home Health | 2301 Woodbridge St Ste 101, Roseville, MN 55113-4716 | 2019-12-11 |
| 1013558659 | Eleanor C Williams | Home Health | 901 Sunrise Ave Ste A16, Roseville, CA 95661-4541 | 2019-10-04 |
| 1508425794 | Dynamic Health Care | Home Health | 2680 Western Ave N, Roseville, MN 55113-2345 | 2019-06-11 |
| 1083176226 | Safeway Home Healthcare LLC | Home Health | 1157 Skillman Ave W, Roseville, MN 55113-5939 | 2019-04-05 |
| 1376019901 | Healing Place Home Care LLC @gmail.com | Home Health | 26601 Clancy St, Roseville, MI 48066-3150 | 2018-10-22 |
| 1336630284 | Alyssa Florez | Home Health | 26342 Grandmont St, Roseville, MI 48066-3236 | 2018-05-27 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.