SHELLY OLSON


Address: 5448 W Island Lake Rd, Duluth, MN 55803-8405
Phone: 2183930233

SHELLY OLSON (NPI# 1801293444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 5448 W ISLAND LAKE RD
City DULUTH
State MN
Zip Code 55803-8405

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City DULUTH
Zip Code 55803

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Dataset Information

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.

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