MEDICARE: SHIFT SOLUTIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	261QM1300X	Multi-Specialty Clinic/Center
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376117663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIFT SOLUTIONS

Provider Business Mailing Address
First Line	:	6697 ELM ST
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-7045
Country	:	US
Telephone Number	:	651-428-2797
Fax Number	:

Provider Business Practice Location Address
First Line	:	6697 ELM ST
Second Line	:
City	:	NORTH BRANCH
State	:	MN
Zip	:	55056-7045
Country	:	US
Telephone Number	:	651-428-2797
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMANDA M KORTUS
Credential	:
Telephone Number	:	651-428-2797

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/19/2021

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Directions to “SHIFT SOLUTIONS ” Practice Location

Language	Start Address	Practice Location

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