SHELLY OLSON (NPI# 1801293444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801293444 |
Entity Type | Individual |
Full Name | SHELLY OLSON |
Practice Address |
5448 W Island Lake Rd Duluth MN 55803-8405 |
Practice Telephone | 2183930233 |
Mailing Telephone | 2183930233 |
Enumeration Date | 2014-11-25 |
Last Update Date | 2014-11-25 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1076151-1-HCBS | MN | Residential Treatment Facilities |
Street Address |
5448 W ISLAND LAKE RD |
City | DULUTH |
State | MN |
Zip Code | 55803-8405 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144872615 | Rosslyn Jean Kendrick | Health Educator | 1926 Lakeview Dr, Duluth, MN 55803 | 2019-07-15 |
1255757191 | Chandra Rose Shoberg | Physical Therapy Assistant | 131 West Wabasha Street, Duluth, MN 55803 | 2014-03-17 |
1053642652 | Kate Elizabeth Matson | Social Worker | 5095 Fish Lake Road, Duluth, MN 55803 | 2010-01-21 |
1972740025 | Danie-marie Osterlund | Marriage & Family Therapist | 4321 Allendale Ave., Duluth, MN 55803 | 2009-01-12 |
1205020419 | Marjorie Lynn Gilbertson | Registered Nurse | 167 Farley Lane, Duluth, MN 55803 | 2007-08-30 |
1497894646 | Jeffrey Keith Somrock | Dentist | 22 E Calvary Rd, Woodland Family Dental Clinic Pa, Duluth, MN 55803 | 2007-02-05 |
1407949167 | The Hills Youth and Family Services | Clinic/Center | 4321 Allendale Avenue, Duluth, MN 55803 | 2006-10-02 |
1942567086 | Carl Peter Rasmussen | Family Medicine | 1400 Woodland Ave, Duluth, MN 55803 | 2012-04-13 |
1285011692 | Chandra J Fischer | Midwife | 3548 W Tischer Rd, Duluth, MN 55803-1124 | 2015-05-05 |
1518143999 | Claudia Virginia Weber | Psychologist | 4298 Charles Rd, Duluth, MN 55803-1270 | 2008-01-15 |
Find all providers in zip 55803 |
Taxonomy Code | 320600000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023360559 | North Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 324 W Superior St Ste 400, Medical Arts Building, Duluth, MN 55802-1726 | 2012-10-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205478849 | Jobs Wholeness House of Prosperity | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 123 Garner Cir, Montrose, MN 55363-8598 | 2019-10-15 |
1639710593 | Alicia Marie Olson | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 25844 10th St W, Zimmerman, MN 55398-8796 | 2019-10-02 |
1841764768 | Stepping Out Incorporated | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 603 3rd St W, Hastings, MN 55033-1127 | 2019-01-14 |
1841652898 | Faiza Hassan | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10917 Humboldt Ave S, Bloomington, MN 55431-4221 | 2016-03-28 |
1306190509 | Ronald Allen Synstelien | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 607 E Fir Ave, Fergus Falls, MN 56537-1503 | 2012-11-09 |
1073742383 | Lutheran Social Service of Minnesota | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 198 Penny Lane, Leroy, MN 55951 | 2009-07-08 |
1952549925 | Coleman Investment | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4001 Willow Rd N, Brooklyn Park, MN 55443-1239 | 2009-01-29 |
1942467683 | Total Living Commitment, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Woodduck Cir, Delano, MN 55328-9779 | 2008-05-20 |
1922285576 | Lakes Homes and Program Development, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1118 West Ave, Detroit Lakes, MN 56501-3210 | 2008-01-25 |
1407045461 | Northland Counseling Center, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1307 S Pokegama Ave, Grand Rapids, MN 55744-4210 | 2007-10-16 |
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.