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General NPI Number Information
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NPI Number | 1750248548
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Entity Type | Organization
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Legal Business Name | MEADOWLARK SERVICES LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 17039 72ND AVE N
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City | MAPLE GROVE
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State | MN
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Zip | 55311-4564
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Country | US
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Telephone | 507-469-2084
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Fax |
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Provider Business Mailing Address
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Address Line | 17039 72ND AVE N
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City | MAPLE GROVE
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State | MN
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Zip | 55311-4564
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Country | US
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Telephone | 507-469-2084
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MICHELLE SANKO
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Credential | MSW, LICSW
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Telephone | 507-469-2084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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