MOUNT OLIVET ROLLING ACRES, INC (NPI# 1003172594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003172594 |
| Entity Type | Organization |
| Organization Name | MOUNT OLIVET ROLLING ACRES, INC |
| Practice Address |
1603 W Old Shakopee Rd Bloomington MN 55431-3065 |
| Mailing Address |
18986 Lake Dr E Chanhassen MN 55317-9348 |
| Practice Telephone | 9524014868 |
| Mailing Telephone | 9524745974 |
| Mailing Fax Number | 9524743652 |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2013-08-01 |
| Authorized Official Name | KARI DOSE (OFFICE MANAGER) |
| Authorized Official Telephone | 9524014843 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659720951 | Mount Olivet Rolling Acres, Inc | Intermediate Care Facility, Mentally Retarded | 18986 Lake Dr E, Chanhassen, MN 55317-9348 | 2016-06-07 |
| 1154675882 | Mount Olivet Rolling Acres, Inc | Home Health | 18986 Lake Dr E, Chanhassen, MN 55317-9348 | 2012-11-02 |
| Street Address |
1603 W OLD SHAKOPEE RD |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55431-3065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679684203 | Colleen S Odonnell | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-08-31 |
| 1790975928 | Stephani Louise Bruyer | Psychologist | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2007-07-25 |
| 1225120991 | Carol Peitzman | Nurse Practitioner | 1603 W Old Shakopee Rd, Bloomington, MN 55431-3065 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
| 1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
| 1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
| 1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
| 1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
| 1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
| Find all providers in zip 55431 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932668795 | Interpersonal Psychotherapy Center | Clinical Nurse Specialist | 300 3rd Ave Se Ste 206, Rochester, MN 55904-4632 | 2019-03-19 |
| 1598065054 | Colleen Margaret Zimmer | Clinical Nurse Specialist | 1150 Montreal Ave Ste 107, Saint Paul, MN 55116-2393 | 2010-10-29 |
| 1275709222 | Suzanne M Lee | Clinical Nurse Specialist | 3361 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2624 | 2008-04-30 |
| 1295936946 | Community Diagnostics and Consultation, Inc | Clinical Nurse Specialist | 5642 Halie Rd, Duluth, MN 55810-2166 | 2007-05-30 |
| 1568594497 | Beth Ann Good | Clinical Nurse Specialist | 145 2nd Ave Se, Cambridge, MN 55008 | 2007-03-09 |
| 1407992449 | Deborah Ann Pariso | Clinical Nurse Specialist | 1433 Highland Pkwy, Saint Paul, MN 55116-2240 | 2007-01-29 |
| 1033271077 | Kathryn Mary Collins | Clinical Nurse Specialist | 3900 55th St. Nw, Va Clinic, Rochester, MN 55901 | 2006-12-15 |
| 1679643522 | Sandra Faye Schleter | Clinical Nurse Specialist | 8085 Wayzata Blvd Suite 101, Bhsi LLC, Golden Valley, MN 55426-1456 | 2006-11-08 |
| 1700955648 | Charlotte Louise Stack | Clinical Nurse Specialist | 882 Sw 15th St., Forest Lake, MN 55025-1331 | 2006-11-07 |
| 1992895437 | Patrice Maria Hebert | Clinical Nurse Specialist | 1617 Skyline Drive, Rochester, MN 55902 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 55431 |
Please comment or provide details below to improve the information on MOUNT OLIVET ROLLING ACRES, INC.
| 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.