MSOCS-BLAINE (NPI# 1508939331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508939331 |
| Entity Type | Organization |
| Organization Name | MSOCS-BLAINE |
| Practice Address |
12949 Kenyon St Ne Minneapolis MN 55449-4991 |
| Mailing Address |
Po Box 64979 Saint Paul MN 55164-0979 |
| Practice Telephone | 7637550233 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | ROGER DENEEN (RESIDENTIAL PROG SVCS DIRECTOR) |
| Authorized Official Telephone | 6515821857 |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTERN MINNESOTA STATE OPERATED COMMUNITY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 424045600 | 05 |
| Street Address |
12949 KENYON ST NE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55449-4991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962692905 | Northeast House Inc | Intermediate Care Facility, Mentally Retarded | 1918 19th Ave Ne, Minneapolis, MN 55418-4728 | 2007-07-26 |
| 1457479636 | People Incorporated | Intermediate Care Facility, Mentally Retarded | 1380 W Minnehaha Pkwy, Minneapolis, MN 55419-5220 | 2007-03-27 |
| 1750441713 | Outreach Six Acres Inc | Intermediate Care Facility, Mentally Retarded | 1555 118th Ln Nw, Minneapolis, MN 55448-7579 | 2006-12-11 |
| 1255416830 | Rem Hennepin Inc | Intermediate Care Facility, Mentally Retarded | 614 Queen Avenue South, Minneapolis, MN 55405 | 2006-10-25 |
| 1518042100 | Rem Hennepin Inc | Intermediate Care Facility, Mentally Retarded | 2311 Pillsbury Avenue South, Minneapolis, MN 55404 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922502418 | Harry Meyering Center, Inc. | Intermediate Care Facility, Mentally Retarded | 2050 Haughton Ave, North Mankato, MN 56003-1416 | 2018-03-20 |
| 1114385085 | Lutheran Social Service of Minnesota | Intermediate Care Facility, Mentally Retarded | 11754 191 1/2 Ave Nw, Elk River, MN 55330-1367 | 2016-02-05 |
| 1255797718 | Lutheran Social Service of Minnesota | Intermediate Care Facility, Mentally Retarded | 497 Gates Ave Nw, Elk River, MN 55330-2633 | 2016-01-13 |
| 1891195608 | Prairie Community Services | Intermediate Care Facility, Mentally Retarded | 2203 Rolling Green Ln, North Mankato, MN 56003-4459 | 2014-08-28 |
| 1336560333 | Rem Woodvale, Inc. Cottonwood | Intermediate Care Facility, Mentally Retarded | 2311 9th Avenue Sw, Austin, MN 55912 | 2013-12-18 |
| 1801228937 | Rem River Bluffs, Inc. Pinewood | Intermediate Care Facility, Mentally Retarded | 2631 Pinewood Ridge Dr Se, Rochester, MN 55904-6227 | 2013-07-31 |
| 1205111770 | Rem Ramsey, Inc. | Intermediate Care Facility, Mentally Retarded | 975 Lakewood Drive, Maplewood, MN 55119 | 2011-10-17 |
| 1306171939 | Rem Ramsey, Inc. | Intermediate Care Facility, Mentally Retarded | 797 Mayhill Rd N, Maplewood, MN 55119-3828 | 2009-10-15 |
| 1003073487 | Harmony Homes of Minnesota LLC | Intermediate Care Facility, Mentally Retarded | 7935 Drake Rd, Woodbury, MN 55125-1446 | 2008-05-22 |
| 1508033580 | Allendale House | Intermediate Care Facility, Mentally Retarded | 3108 Highway 52 N, Rochester, MN 55901-1916 | 2008-05-09 |
| Find all providers with the same taxonomy | ||||
| City | MINNEAPOLIS |
| Zip Code | 55449 |
Please comment or provide details below to improve the information on MSOCS-BLAINE.
| 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.