Healthcare Provider Details

I. General information

NPI: 1295468502
Provider Name (Legal Business Name): SENSE-ATIONAL SPACES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 07/05/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11517 POLK ST NE
BLAINE MN
55434-2959
US

IV. Provider business mailing address

11517 POLK ST NE
BLAINE MN
55434-2959
US

V. Phone/Fax

Practice location:
  • Phone: 651-233-7436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ALEXI MERCEDES CHRISTENSEN
Title or Position: CO-OWNER, CEO
Credential: MA, OTR/L
Phone: 651-233-7436