Eagle's Crossing Adult Day Center (Mora Eaglet)

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

1062197 Issued in MN

Legal business name

EAGLE'S CROSSING ADULT DAY CENTER (MORA EAGLET)

Practice address

133 Union St S Ste 4
Mora, MN 55051-1579

Phone

(320) 285-3128

NPI assigned

Mar 28, 2012

Last updated

Mar 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Diane Kay Kramer

Title

Owner/ Adult Day Director

Phone

(320) 285-3128

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1053687533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 UNION ST S STE 4",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511579",
            "telephone_number": "320-285-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 UNION ST S STE 4",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511579",
            "telephone_number": "320-285-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE'S CROSSING ADULT DAY CENTER (MORA EAGLET)",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/ ADULT DAY DIRECTOR",
        "authorized_official_telephone_number": "320-285-3128",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MN",
            "license": "1062197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Sue Deutschlander, RN, CNP
• Peter J Donner, MD
• Dr. James Knutson
• Rachel Erika Dubay, MD
• Kati Jean Dvorak, PHARM D
• East Central Behavioral Health LLC
• Tasha Eggert, LADC
• Jacob Ryan Ellingson, MSPT, SCS, ATC, CSCS
• Barbara Lou Ennis, NP
• Garrett Estenson, PT, DPT, MBA

• Adult Day Care Clinic/Center in Mora, MN
• Providers in Mora, MN by specialty
• Adult Day Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.