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General NPI Number Information
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NPI Number | 1508302027
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Entity Type | Organization
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Legal Business Name | ZANDU HEALTH INITIATIVE
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Dates
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Enumeration Date | 01/08/2017
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 10800 LYNDALE AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55420-5614
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Country | US
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Telephone | 952-208-5590
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Fax | 612-446-5500
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Provider Business Mailing Address
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Address Line | 10800 LYNDALE AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55420-5614
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Country | US
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Telephone | 952-479-0172
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Fax | 952-516-5393
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. STEVE MANDIEKA
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Credential |
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Telephone | 952-479-0172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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