NPIMap

Organization Active NPI

Cerulean Minds Support Services

  • Early Intervention Provider Agency
  • Burnsville, MN
National Provider Identifier
1023772811
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
CERULEAN MINDS SUPPORT SERVICES
Practice address
1609 Southcross Dr W
Burnsville, MN 55306-7013
Phone
(952) 769-4299
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Abdihakim Ibrahim
Title
Manager
Phone
(763) 442-1507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1609 Southcross Dr W
Burnsville, MN 55306-7013

Mailing address

1609 Southcross Dr W
Burnsville, MN 55306-7013
Phone (952) 769-4299

National Provider Directory

National Provider Directory

Locations

1609 Southcross Dr W
Burnsville, MN 55306
Phone (952) 769-4299

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635292800000",
    "number": "1023772811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553067013",
            "telephone_number": "952-769-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553067013",
            "telephone_number": "952-769-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERULEAN MINDS SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "ABDIHAKIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "763-442-1507"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.