INTERIM HEALTHCARE OF LAKE SUPERIOR, INC. (NPI# 1417950874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417950874 |
| Entity Type | Organization |
| Organization Name | INTERIM HEALTHCARE OF LAKE SUPERIOR, INC. |
| Practice Address |
332 W Superior St Suite 204 Duluth MN 55802 |
| Practice Telephone | 2187220053 |
| Practice Fax Number | 2187220318 |
| Mailing Telephone | 2187220053 |
| Mailing Fax Number | 2187220318 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2019-10-08 |
| Authorized Official Name | KARI JO JARVI (CONTROLLER) |
| Authorized Official Telephone | 2187220053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | 327241 | MN | Agencies |
| Y | 251E00000X | Home Health | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 41529800 | 05 | |
| MN | BLUE CROSS BLUE SHIELD | 8569IN | 01 |
| MN | 964355900 | 05 | |
| MN | UCARE | 109638 | 01 |
| MN | MEDICA | 59-00052 | 01 |
| MN | 96435590 | 05 |
| Other Name | Type Code |
|---|---|
| Interim HealthCare | Doing Business As Name - Organization |
| Street Address |
332 W SUPERIOR ST SUITE 204 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699202382 | Holly Laluzerne | Counselor | 332 W Superior St, Suite 300, Duluth, MN 55802 | 2017-05-12 |
| 1437685427 | Hilary Taylor Brown | Counselor | 332 W Superior St, Suite Number: 300, Duluth, MN 55802-1808 | 2017-05-11 |
| 1205388691 | Christopher David Denzler | Counselor | 332 W Superior St, Suite 300, Duluth, MN 55802-1808 | 2016-11-01 |
| 1043766835 | Ralph Borchardt I | Counselor | 332 W Superior St, Duluth, MN 55802-1808 | 2016-08-31 |
| 1205289329 | Carleton Saxton | Counselor | 332 W Superior St, Duluth, MN 55802-1808 | 2016-07-14 |
| 1285086835 | Ashley Lynn Tuve | Counselor | 332 W Superior St, Suite 300, Duluth, MN 55802-1808 | 2016-07-07 |
| 1831549260 | Angela Khalar | Social Worker | 332 W Superior St, Suite 300, Duluth, MN 55802-1808 | 2016-06-16 |
| 1932565603 | Jessica Ruth Klasen | Counselor | 332 W Superior St, Duluth, MN 55802-1808 | 2016-01-11 |
| 1063877835 | Beth Anderson | Social Worker | 332 W Superior St, Duluth, MN 55802-1808 | 2015-12-22 |
| 1912372632 | Katie Lyn Jensen | Marriage & Family Therapist | 332 W Superior St, Suite 300, Duluth, MN 55802-1808 | 2015-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| 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] |
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| 1790303444 | Latravia Lishell Williams | Home Health | 1335 Herrington Rd Apt 2722, Duluth, GA 30096-6422 | 2020-07-09 |
| 1528685138 | M. A. Health Services, Inc. | Home Health | 3973 Stillwater Dr, Duluth, GA 30096-5589 | 2020-06-30 |
| 1639795610 | Dunamis Healthcare Services | Home Health | 2028 The Falls Pkwy, Duluth, GA 30096-8805 | 2020-06-25 |
| 1598233231 | Provider Partners, LLC Dba Your Virtual Clincial | Home Health | 1815 Satellite Blvd Ste 403, Duluth, GA 30097-5239 | 2018-11-12 |
| 1427532704 | 1st Option Healthcare,llc | Home Health | 1810 Peachtree Industrial Blvd Ste 215, Duluth, GA 30097-8177 | 2018-09-21 |
| 1306326475 | Caringcompanions Home Care Services LLC | Home Health | 3121 Barkley Square Dr, Duluth, GA 30097-3453 | 2018-08-18 |
| 1306359179 | Anthony Olajide | Home Health | 3780 Old Norcross Rd # 103-366, Duluth, GA 30096-1740 | 2017-11-14 |
| 1437678885 | Teleigha L Peavy | Home Health | 2695 Kingsbrooke Ln, Duluth, GA 30097-7392 | 2017-09-18 |
| 1194250233 | Katie T Dang | Home Health | 4370 Satellite Blvd, #834, Duluth, GA 30096-8843 | 2017-04-26 |
| Find all providers in DULUTH | ||||
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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.