TRICIA BASTIAN (NPI# 1295291573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295291573 |
Entity Type | Individual |
Full Name | TRICIA BASTIAN |
Practice Address |
607 4th St S Walker MN 56484-6400 |
Mailing Address |
Po Box 910 Walker MN 56484-0910 |
Practice Telephone | 2182511365 |
Mailing Telephone | 2182511365 |
Enumeration Date | 2019-02-12 |
Last Update Date | 2019-02-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1098115 | MN | Residential Treatment Facilities |
Street Address |
607 4TH ST S |
City | WALKER |
State | MN |
Zip Code | 56484-6400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265058259 | Janna Wiele | Social Worker | 301 4th St S, Walker, MN 56484 | 2020-06-25 |
1649831264 | Alyssa Sharon Robley | Physical Therapist | 106 Fifth St S, Walker, MN 56484 | 2019-06-25 |
1447733639 | Walker Adult Day Services | Clinic/Center | 6835 Cranberry Bog Trl Nw, Walker, MN 56484 | 2018-09-13 |
1750827234 | Walker Operations LLC | Skilled Nursing Facility | 209 Birchwood Avenue West, Walker, MN 56484 | 2017-01-09 |
1699178707 | David Farder | Physical Therapist | 106 5th St S, Walker, MN 56484 | 2014-10-02 |
1083053292 | Gary F Wehrwein | Pharmacist | 1523 Suzanne Drive Ne, Longville, MN 56484 | 2013-06-20 |
1306141882 | First Choice Therapy | Clinic/Center | 6068 E Ottertail Rd Nw, Walker, MN 56484 | 2011-01-14 |
1033421029 | Walker Wellness Chiropractic Center, Pa | Chiropractor | 215 Garden Street, Walker, MN 56484 | 2010-07-08 |
1538343496 | Walker Wellness Chiropractic | Chiropractor | 507 Front Street West, Walker, MN 56484 | 2007-12-27 |
1629263827 | Shingobee Island Lodge Incorporated | Community Based Residential Treatment Facility, Mental Illness | 7185 Dewdrop Trail Nw, Walker, MN 56484 | 2007-09-11 |
Find all providers in zip 56484 |
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 |
---|---|---|---|---|
1023230521 | La Trouve' Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30334 Milton Drive, Walker, LA 70785 | 2007-05-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184244527 | Kam Homecare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1500 Nicollet Ave Apt 305, Minneapolis, MN 55403-2724 | 2020-04-24 |
1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
1881163632 | Jacob Wrich | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 3rd St W Apt 1, Hastings, MN 55033-1127 | 2018-11-21 |
1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
1154814564 | Laurie K. Tazelaar-williams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532 | 2018-06-11 |
1205340577 | Dale Conrad Forslin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1029 Highway 65 Ste 107, Braham, MN 55006-3360 | 2017-11-25 |
1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
1407396336 | Viko Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5651 69th Ave N, 203, Brooklyn Park, MN 55429-1579 | 2017-02-25 |
1972052702 | Marie-noel Hiol-hiol | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14642 Quartz Ter Nw, Ramsey, MN 55303-4581 | 2016-09-21 |
1750839569 | Kubra Residential Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1711 W 143rd St Apt 120, Burnsville, MN 55306-7989 | 2016-09-21 |
Find all providers with the same taxonomy |
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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.