COMMUNITY CONNECTION OF MINNESOTA INC (NPI# 1801843206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801843206 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CONNECTION OF MINNESOTA INC |
| Practice Address |
4014 Pitt St Duluth MN 55804-1956 |
| Mailing Address |
4014 Pitt Street Duluth MN 55804-1956 |
| Practice Telephone | 2185254126 |
| Practice Fax Number | 2185255862 |
| Mailing Telephone | 2185254126 |
| Mailing Fax Number | 2185255862 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHARON MACK (CEO) |
| Authorized Official Telephone | 2185254126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
4014 PITT ST |
| City | DULUTH |
| State | MN |
| Zip Code | 55804-1956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235593591 | Michelle Leblanc | Speech-Language Pathologist | 5017 London Rd., Duluth, MN 55804 | 2016-04-12 |
| 1346541075 | Christina Finlo | Marriage & Family Therapist | 4849 Ivanhoe St, Duluth, MN 55804 | 2010-11-11 |
| 1821301623 | Rachel Gabrielle Ashford | Social Worker | 5107 E Superior St, Duluth, MN 55804 | 2010-07-21 |
| 1932381423 | Janet Florence Lewis | Registered Nurse | 4231 Dodge Street, Duluth, MN 55804 | 2007-11-27 |
| 1245419894 | Ernest Carl Hansen | Physical Therapist | 4002 London Rd., Duluth, MN 55804 | 2007-10-31 |
| 1316011596 | Melissa J. Janzen | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2006-11-20 |
| 1861406522 | Susan Klee Anderson | Family Medicine | 4621 E Superior St., Duluth, MN 55804 | 2006-07-28 |
| 1104886977 | Sarah Adeen Ziring | Physical Therapist | 4621 E Superior St, Duluth, MN 55804 | 2006-03-24 |
| 1285831040 | Janzen Chiropractic Pa | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2007-06-27 |
| 1912121708 | Cooley Chiropractic Clinic, Inc. | Chiropractor | 5722 Homestead Rd, Duluth, MN 55804 | 2007-04-12 |
| Find all providers in zip 55804 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225289960 | Tracy Curley | Custodial Care Facility | 547 Glenwood St, Duluth, MN 55803-2178 | 2008-09-30 |
| 1487802450 | Guided Transitions LLC | Custodial Care Facility | 905 N Basswood Ave, Duluth, MN 55811-5100 | 2008-09-03 |
| 1699953547 | Moving Forward Afc LLC | Custodial Care Facility | 3409 Commonwealth Ave, Duluth, MN 55808-1306 | 2008-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043844384 | First Mercy Homes LLC | Custodial Care Facility | 15723 Fair Hill Way, Apple Valley, MN 55124-5256 | 2020-02-25 |
| 1386275980 | Krista Maylene Tupker | Custodial Care Facility | 14490 Lynx Rd, Milaca, MN 56353-3019 | 2020-02-01 |
| 1437700499 | Amanda Sue Moen | Custodial Care Facility | 700 105th St Nw, Rice, MN 56367-8656 | 2019-09-21 |
| 1467006601 | Michelle M Green | Custodial Care Facility | 13709 Apollo Way, Rosemount, MN 55068-2171 | 2019-07-25 |
| 1750947743 | Victor G. Makori | Custodial Care Facility | 17017 Georgetown Way, Rosemount, MN 55068-5159 | 2019-05-15 |
| 1134698814 | Sharry Mae Stensrud | Custodial Care Facility | 25 E Broadway, Plainview, MN 55964-1531 | 2018-11-25 |
| 1770080442 | Christophe Benzi | Custodial Care Facility | 1403 Nicole Ct, Fergus Falls, MN 56537-3326 | 2018-04-10 |
| 1225542608 | All Hopes Incorporated | Custodial Care Facility | 9937 Linnet St Nw, Coon Rapids, MN 55433-4721 | 2017-11-21 |
| 1003368309 | Amazing Love Elderly Care Center LLC | Custodial Care Facility | 7807 Emerald Rd, Randall, MN 56475-2428 | 2016-11-03 |
| 1902268857 | Gaudencio Fuentes Celeste | Custodial Care Facility | 8674 134th St W, Apple Valley, MN 55124-7234 | 2016-03-21 |
| 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.