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NPI Code Detail

MEDICARE: CENTER FOR AFRICANS NEW TO AMERICA,INC.

MEDICARE: CENTER FOR AFRICANS NEW TO AMERICA,INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency365664MN
2253Z00000XIn Home Supportive Care Agency365664MN
3252Y00000XEarly Intervention Provider Agency365664MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1625OTHERMNMN GMHA,MA,MINNESOTACARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174856017
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR AFRICANS NEW TO AMERICA,INC.
Provider Business Mailing Address
First Line : 11712 CARTIER AVE S
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-3227
Country : US
Telephone Number : 952-356-2953
Fax Number : 612-276-1535
Provider Business Practice Location Address
First Line : 3333 N 4TH ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-2615
Country : US
Telephone Number : 612-276-1535
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. KATE U ONYENEHO
Credential : ASD
Telephone Number : 612-236-1535
Provider Enumeration Date : 09/10/2009
Last Update Date : 09/10/2009

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