OUR HOMES SOUTH, INC (NPI# 1184705634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184705634 |
Entity Type | Organization |
Organization Name | OUR HOMES SOUTH, INC |
Practice Address |
113 North Main Street Medford MN 55049-0119 |
Mailing Address |
Po Box 119 Medford MN 55049-0119 |
Practice Telephone | 5074552114 |
Practice Fax Number | 5074552178 |
Mailing Telephone | 5074552114 |
Mailing Fax Number | 5074552178 |
Enumeration Date | 2006-10-18 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. DENNIS KLAUS BURGESS (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 5074552114 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8092892WS | MN | Residential Treatment Facilities |
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8065272WS | MN | Residential Treatment Facilities |
Street Address |
113 NORTH MAIN STREET |
City | MEDFORD |
State | MN |
Zip Code | 55049-0119 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093969107 | Renae Dawn Blome | Dental Hygienist | 4366 270th St E, Medford, MN 55049-8001 | 2008-11-17 |
1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
1598323453 | Refine Service Coordination Pllc | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-06-04 |
1245397603 | Isd 763 Medford Public School | Local Education Agency (LEA) | 750 2nd Ave Se, Medford, MN 55049-9586 | 2007-01-03 |
1295207215 | Joseph J Claeys | Social Worker | 750 2nd Ave Se, Medford, MN 55049-9586 | 2019-01-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174124226 | Shane William Macdonald | Social Worker | 20 Stearns Ave, Medford, MA 02155-5620 | 2020-11-05 |
1386245934 | Stephen Choi | Pharmacist | 12 Blakely Rd, Medford, MA 02155-2409 | 2020-11-02 |
1235739277 | Total Body Knowledge | Dietitian, Registered | 2314 Hempstead St Apt 3, Medford, OR 97501-0259 | 2020-10-29 |
1366042418 | Sarah Hassan | Registered Nurse | 298 Fellsway W, Medford, MA 02155-2646 | 2020-10-28 |
1720688021 | Edward Cutler | Phlebology | 724 S Central Ave Ste 206, Medford, OR 97501-7833 | 2020-10-27 |
1801496310 | Dyshonia Louise Dent | Licensed Practical Nurse | 1102 Lake Dr, Medford, NY 11763-4620 | 2020-10-26 |
1922607464 | Rogue Therapy | Community/Behavioral Health | 328 S Central Ave Ste 213, Medford, OR 97501-7274 | 2020-10-24 |
1295334118 | Moriah J Spendolini | Behavioral Analyst | 3709 Citation Way, Medford, OR 97504-9022 | 2020-10-21 |
1245839372 | Giovanni Germain | Behavior Technician | 29 Fells Avenue Ter, Medford, MA 02155-1913 | 2020-10-20 |
1821696261 | Julia Elizabeth Erskine | Student in an Organized Health Care Education/Training Program | 119 Boston Ave Apt 1, Medford, MA 02155-3570 | 2020-10-16 |
Find all providers in MEDFORD |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134762065 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1703 Cedar Dr, Medford, NJ 08055-2322 | 2019-10-23 |
1164998340 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 707 Eugenia Dr, Medford, NJ 08055-2312 | 2018-10-16 |
1265968572 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Eugenia, Medford, NJ 08055 | 2017-05-05 |
1326574690 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1503 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
1780110007 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1610 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
1902332216 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1909 Cedar Dr, Medford, NJ 08055 | 2017-05-05 |
1083140396 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 503 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
1457887762 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 905 Eugenia Dr, Medford, NJ 08055 | 2017-05-05 |
1740716133 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1509 Cedar Dr, Medford, NJ 08055 | 2017-05-04 |
1831625227 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1701 Cedar Dr, Medford, NJ 08055 | 2017-05-04 |
Find all providers in MEDFORD |
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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.