GREAT LAKES ARMS PROGRAM (NPI# 1508477514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508477514 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ARMS PROGRAM |
| Practice Address |
2917 15th Ave S Minneapolis MN 55407-1427 |
| Practice Telephone | 6124147739 |
| Mailing Telephone | 6124147739 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | ABDIRAHMAN DHUNKAL (BOARD MEMBER) |
| Authorized Official Telephone | 6124147739 |
| Authorized Official Credential | BOARD MEMBER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
2917 15TH AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55407-1427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
| 1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
| 1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
| 1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
| 1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
| 1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
| Find all providers in zip 55407 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235746579 | Kesha L Bradford | Counselor | 4315 Irving Ave N, Minneapolis, MN 55412-1258 | 2020-09-30 |
| 1043826746 | Amanda Anderson | Counselor | 3201 1st Ave S, Minneapolis, MN 55408-4407 | 2020-09-17 |
| 1467077073 | Mandy Don Schloesser | Counselor | 2755 Grand St Ne, Minneapolis, MN 55418-2611 | 2020-06-09 |
| 1275156473 | Megan Rose Relson | Counselor | 3111 Mckinley St Ne, Minneapolis, MN 55418-2333 | 2020-05-21 |
| 1699307967 | Minneapolis Autism Center Corp | Counselor | 621 E 38th St, Minneapolis, MN 55407-2571 | 2020-02-05 |
| 1366083438 | John Arthur Flannagan | Counselor | 4037 13th Ave S, Minneapolis, MN 55407-3243 | 2019-09-30 |
| 1790331262 | Heather O'brien | Counselor | 2200 E Franklin Ave Ste 200, Minneapolis, MN 55404-2395 | 2019-08-12 |
| 1023679750 | Sarah Haag | Counselor | 800 E 28th St Wasie, Minneapolis, MN 55407-3723 | 2019-06-24 |
| 1447721634 | Patricia Marie Reinecke Lebedeva | Counselor | 2021 E Hennepin Ave Ste 330, Minneapolis, MN 55413-1798 | 2018-12-16 |
| 1417423229 | Ian D Felton | Counselor | 2012 Bryant Ave S Ste 4, Minneapolis, MN 55405-2819 | 2018-10-18 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55407 |
Please comment or provide details below to improve the information on GREAT LAKES ARMS PROGRAM.
| 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.