LAURIE K. TAZELAAR-WILLIAMS


Address: 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532
Phone: 6123803333

LAURIE K. TAZELAAR-WILLIAMS (NPI# 1154814564) 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) 1154814564
Entity Type Individual
Full Name LAURIE K. TAZELAAR-WILLIAMS
Practice Address 5253 W Bald Eagle Blvd
White Bear Lake
MN 55110-6532
Mailing Address Po Box 10818
White Bear Lake
MN 55110-0818
Practice Telephone 6123803333
Mailing Telephone 6123803333
Enumeration Date 2018-06-11
Last Update Date 2018-06-11
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities MN Residential Treatment Facilities

Office Location

Street Address 5253 W BALD EAGLE BLVD
City WHITE BEAR LAKE
State MN
Zip Code 55110-6532

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1467071084 St. Catherine University School Based Health Clinic Nurse Practitioner 5045 Division Ave, White Bear Lake, MN 55110 2020-04-14
1922450618 Lisa Marie Thatcher Podiatrist 4653 White Bear Pkwy., St. Paul, MN 55110 2016-07-06
1558725598 White Bear Dentists, PC Dentist 1970 Buerkle Road, White Bear Lake, MN 55110 2016-04-06
1124486246 Julie Blaske Counselor 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 2016-02-03
1851761514 Supervalu Pharmacies Inc Durable Medical Equipment & Medical Supplies 1920 Buerkle Rd, White Bear Lake, MN 55110 2015-10-06
1821496969 Leah Eichmiller Acupuncturist 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 2014-12-05
1447672084 Ashley Rath Chiropractor 1247 Gun Club Rd., White Bear Lake, MN 55110 2014-01-16
1790121291 Advanced Medical Home Care, LLC Home Health 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 2013-05-11
1134468465 Emergency Physicians Professional Association Clinic/Center 1159 E. County Road E, Vadnais Heights, MN 55110 2013-02-06
1639444284 Rebecca Lynn Blaede Counselor 4858 Banning Avenue, White Bear Lake, MN 55110 2012-03-15
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and state

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
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
1750839569 Kubra Residential Center Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1711 W 143rd St Apt 120, Burnsville, MN 55306-7989 2016-09-21
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Competitor

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City WHITE BEAR LAKE
Zip Code 55110

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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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