Healthcare Provider Details

I. General information

NPI: 1154737278
Provider Name (Legal Business Name): DEAF & IMMIGRANT CENTER FOR EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 36TH AVE S
MINNEAPOLIS MN
55406-2756
US

IV. Provider business mailing address

3708 36TH AVE S
MINNEAPOLIS MN
55406-2756
US

V. Phone/Fax

Practice location:
  • Phone: 651-335-9113
  • Fax:
Mailing address:
  • Phone: 651-335-9113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: NATHAN GRANT ELLIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: NIC
Phone: 651-335-9113