DIVERSITY HEALTH SERVICE LLC (NPI# 1164046926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164046926 |
| Entity Type | Organization |
| Organization Name | DIVERSITY HEALTH SERVICE LLC |
| Practice Address |
7900 International Dr Ste 300 Bloomington MN 55425-2562 |
| Practice Telephone | 6128345913 |
| Mailing Telephone | 6128345913 |
| Enumeration Date | 2020-06-07 |
| Last Update Date | 2020-06-07 |
| Authorized Official Name | MR. MOHAMED ARAB (CEO) |
| Authorized Official Telephone | 6128345913 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Street Address |
7900 INTERNATIONAL DR STE 300 |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55425-2562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407487879 | Michelle Fitzpatrick | Social Worker | 7900 International Dr Ste 300, Bloomington, MN 55425-2562 | 2020-02-03 |
| 1770114142 | Internal Expressions In Psychology, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7900 International Dr Ste 300, Bloomington, MN 55425-2562 | 2020-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1134773419 | Fairview Clinics | Clinic/Center | 322 E. Broadway Suite E322, Bloomington, MN 55425 | 2019-07-25 |
| 1548730328 | Che Doua Thao | Pharmacy Technician | Leafline Labs, Eagan, MN 55425 | 2018-12-05 |
| 1235645763 | Caringhands Adult Day Center | Chore Provider | 8040 Old Cedar Ave South Suite # 1, Bloomington, MN 55425 | 2017-12-20 |
| 1174044119 | Abs Holdings, Inc. | In Home Supportive Care | 2626 East 82nd St., Suite 145, Bloomington, MN 55425 | 2017-06-29 |
| 1598144891 | Matthew Runde | Family Medicine | Riverway Clinic Anoka 601 Jacob Lane, Anoka, MN 55425 | 2015-05-20 |
| 1336578145 | Rebecca Ann Lund | Counselor | 8011 34th Avenue South, Suite 206, Bloomington, MN 55425 | 2013-11-02 |
| 1578902250 | Promise Care, Inc | Home Health | 7900 International Drive, Suite 300, Bloomington, MN 55425 | 2013-06-17 |
| 1336292911 | Gane Marie Boothroyd | Optometrist | 304 N. Garden, Mall of America, Bloomington, MN 55425 | 2007-01-18 |
| 1841341898 | Visual Edge, Inc | Technician/Technologist | W 385 West Market, Mall of America, Bloomington, MN 55425 | 2007-01-16 |
| Find all providers in zip 55425 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112975 | Hero Autism Center LLC | Clinic/Center | 3040 4th Ave S Ste 106, Minneapolis, MN 55408-2409 | 2020-10-21 |
| 1538794672 | Star Health Services | Clinic/Center | 2833 13th Ave S Ste 127, Minneapolis, MN 55407-1417 | 2020-03-09 |
| 1255825345 | Senzilla Health Services, LLC | Clinic/Center | 3035 Old Highway 8, Suite 101f, St. Anthony, MN 55418 | 2018-06-21 |
| 1083105209 | Madina Wellness Center, Inc. | Clinic/Center | 1230 Eagan Industrial Rd Ste 103, Eagan, MN 55121-1243 | 2018-05-23 |
| 1447507942 | Little Bird Psc | Clinic/Center | 48858 Us 71, Laporte, MN 56461-4879 | 2012-08-14 |
| 1033347331 | Rosenberg Center Assessment and Treatment for Children & Families Pa | Clinic/Center | 1935 Country Road B2 West, Suite 100, Roseville, MN 55113 | 2009-06-24 |
| 1235397381 | Brenda Jean Hansen | Clinic/Center | 425 6th Avenue West, Floodwood, MN 55736 | 2008-05-27 |
| 1164072906 | Mary Pumper | Clinic/Center | 14301 Ewing Ave S, Burnsville, MN 55306-4885 | 2019-09-13 |
| 1013572056 | Scitech Academy | Clinic/Center | 100 W 66th St, Richfield, MN 55423-2371 | 2019-05-06 |
| 1881035624 | Sandra Streitman Pllc | Clinic/Center | 9031 W 34th St, St Louis Park, MN 55426-3703 | 2013-07-09 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 55425 |
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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.