KUBRA RESIDENTIAL CENTER (NPI# 1750839569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750839569 |
Entity Type | Organization |
Organization Name | KUBRA RESIDENTIAL CENTER |
Practice Address |
1711 W 143rd St Apt 120 Burnsville MN 55306-7989 |
Practice Telephone | 6122244343 |
Mailing Telephone | 6122244343 |
Enumeration Date | 2016-09-21 |
Last Update Date | 2016-09-21 |
Authorized Official Name | MS. KAWSAR ABDI JAMA (OWNER) |
Authorized Official Telephone | 6122244343 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
1711 W 143RD ST APT 120 |
City | BURNSVILLE |
State | MN |
Zip Code | 55306-7989 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568095438 | Roers Senior Living Burnsville LLC | Assisted Living Facility | 14401 Grand Avenue, Burnsville, MN 55306 | 2020-02-19 |
1639717986 | Kaylee Nadine Frederickson | Speech-Language Pathologist | 14451 Grand Ave S, Burnsville, MN 55306 | 2019-12-17 |
1780236893 | Nichole Arn | Occupational Therapist | 14301 Ewing Avenue, Burnsville, MN 55306 | 2019-07-10 |
1942708516 | Nicholas John Solverson | Chiropractor | 14671 Chicago Ave Apt 6, Burnsville, MN 55306 | 2018-01-29 |
1164978672 | Benjamin Halpern | Dentist | 14344 Burnhaven Drive, Burnsville, MN 55306 | 2016-08-26 |
1528478336 | Michael Patrick Hennes | Chiropractor | 14587 Grand Ave Ste 112, Burnsville, MN 55306 | 2014-05-01 |
1467799924 | Dentalign, Pa | Dentist | 2999 County Road 42 W Suite 138, Burnsville, MN 55306 | 2013-01-03 |
1417205436 | Heather Heide | Student in an Organized Health Care Education/Training Program | 14750 Lac Lavon Dr, Burnsville, MN 55306 | 2012-08-23 |
1427243898 | Rehana Leila Ahmed-saucedo | Dermatology | 14305 Southcross Dr, Suite 110, Burnsville, MN 55306 | 2007-09-10 |
1881815397 | Kyle James Colbert | Chiropractor | 745 Crystal Lake Rd East, Burnsville, MN 55306 | 2007-05-01 |
Find all providers in zip 55306 |
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 |
---|---|---|---|---|
1891198792 | Misti Farrow | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12751 Cty Rd 5 Suite 172, Burnsville, MN 55337 | 2014-10-06 |
1225170343 | Yancey Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35 Celo St, Burnsville, NC 28714-3008 | 2007-02-13 |
1376924803 | Rha Health Services Nc, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35 Celo St, Burnsville, NC 28714-3008 | 2015-06-10 |
1285819029 | Yancey Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35 Celo St, Burnsville, NC 28714-3008 | 2007-12-28 |
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 |
1295291573 | Tricia Bastian | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 4th St S, Walker, MN 56484-6400 | 2019-02-12 |
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 |
Find all providers with the same taxonomy |
City | BURNSVILLE |
Zip Code | 55306 |
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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.