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NPI Code Detail

MEDICARE: KALEIDOSCOPE PROFESSIONAL SERVICES

MEDICARE: KALEIDOSCOPE PROFESSIONAL SERVICES
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 Agency

General Provider Information

NPI Number : 1437784162
Entity Type Code : Organization
Provider Name (Legal Business Name) : KALEIDOSCOPE PROFESSIONAL SERVICES
Provider Business Mailing Address
First Line : 5251 JAMES AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55430-3445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5251 JAMES AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55430-3445
Country : US
Telephone Number : 650-500-0191
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MICHELLE VOIGT
Credential :
Telephone Number : 650-500-0191
Provider Enumeration Date : 03/03/2020
Last Update Date : 03/06/2020

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Directions to “KALEIDOSCOPE PROFESSIONAL SERVICES ” Practice Location

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