PLATEAU HEALTHCARE MAPLE GROVE LLC (NPI# 1811544166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811544166 |
| Entity Type | Organization |
| Organization Name | PLATEAU HEALTHCARE MAPLE GROVE LLC |
| Practice Address |
9962 104th Ave N Maple Grove MN 55369-2941 |
| Mailing Address |
8848 Zealand Ave N Ste B Brooklyn Park MN 55445-1891 |
| Practice Telephone | 7634441361 |
| Practice Fax Number | 7634441358 |
| Mailing Telephone | 7634441361 |
| Mailing Fax Number | 7634441358 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |
| Authorized Official Name | MR. FAISALE BOUKARI (PRESIDENT) |
| Authorized Official Telephone | 7634441361 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| Y | 251J00000X | Nursing Care | Agencies |
| Other Name | Type Code |
|---|---|
| PHC Maple Grove | Doing Business As Name - Organization |
| Street Address |
9962 104TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 251J00000X |
| Grouping | Agencies |
| Classification | Nursing Care |
| A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283044 | Tc Healthcare | Nursing Care | 505 Highway 169 N Ste 255, Plymouth, MN 55441-6463 | 2020-10-19 |
| 1215546858 | B&l Anesthesia | Nursing Care | 5006 Woodlawn St, Duluth, MN 55804-1180 | 2020-07-29 |
| 1114535473 | Premium Health Care Inc. | Nursing Care | 1 W Lake St Apt 221, Minneapolis, MN 55408-3151 | 2020-07-22 |
| 1477170231 | Midwest Group Homes LLC | Nursing Care | 1411 W Saint Germain St Ste 6, Saint Cloud, MN 56301-4179 | 2020-06-28 |
| 1427672021 | Caring Rose Homes LLC | Nursing Care | 1043 Hague Ave, Saint Paul, MN 55104-6520 | 2020-05-31 |
| 1164043683 | Nina Philicia Bangu | Nursing Care | 18837 Smith Dr Nw, Elk River, MN 55330-7510 | 2020-05-06 |
| 1861012700 | Open Arms Group Home LLC | Nursing Care | 1 W Lake St Suite 165 Unit 7, Minneapolis, MN 55408 | 2020-04-21 |
| 1154941128 | Gentle Haven | Nursing Care | 8045 159th St W, Apple Valley, MN 55124-7054 | 2020-04-20 |
| 1659991545 | Belong Health Care | Nursing Care | 4809 Oxborough Gdns, Brooklyn Park, MN 55443-3993 | 2020-04-20 |
| 1316574007 | Hope Wellness Center Inc. | Nursing Care | 3119 4th Ave S, Minneapolis, MN 55408-3231 | 2020-03-24 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.