MEDICARE: MEADOWLARK SERVICES LLC

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
1	251S00000X	Community/Behavioral Health Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1750248548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOWLARK SERVICES LLC

Provider Business Mailing Address
First Line	:	17039 72ND AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4564
Country	:	US
Telephone Number	:	507-469-2084
Fax Number	:

Provider Business Practice Location Address
First Line	:	17039 72ND AVE N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-4564
Country	:	US
Telephone Number	:	507-469-2084
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	MICHELLE SANKO
Credential	:	MSW, LICSW
Telephone Number	:	507-469-2084

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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