Healthcare Provider Details

I. General information

NPI: 1780843755
Provider Name (Legal Business Name): NE DINNERBELL MEALS ON WHEELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 TAYLOR ST NE
MINNEAPOLIS MN
55418-3731
US

IV. Provider business mailing address

2511 TAYLOR ST NE
MINNEAPOLIS MN
55418
US

V. Phone/Fax

Practice location:
  • Phone: 612-623-3363
  • Fax:
Mailing address:
  • Phone: 612-789-6548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number126620100
License Number StateMN

VIII. Authorized Official

Name: EILEEN HAFFTEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-623-3363