Southside Care Center

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

License

334535 Issued in MN

Legal business name

SOUTHSIDE CARE CENTER

Practice address

2644 Aldrich Ave S
Minneapolis, MN 55408-1307

Phone

(612) 819-5606

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Alan Kronfeld

Title

Manager, Mis

Phone

(612) 819-5606

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Clemencia Rasquinha, M.D

  • Geriatric Medicine (Family Medicine) Physician
  • Golden Valley, MN
  • NPI 1023021409
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063565398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 BEVERLY AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554225221",
            "telephone_number": "612-819-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2644 ALDRICH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081307",
            "telephone_number": "612-819-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRONFELD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "MANAGER, MIS",
        "authorized_official_telephone_number": "612-819-5606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "MN",
            "license": "334535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southdale Allergy and Asthma Clinic, LLC
• Southdale Therapy Center LLC
• Southeast Asian Refugee Community Home
• Southgate Physical Therapy , LTD
• Southpointe Physical Therapy LLC
• Southside Catering
• Southside Chiropractic, P.a.
• Southside Community Health Services, Inc.
• Southside Community Health Services, Inc. (Southside East Lake Street Dental Clinic)
• Southside Community Health Services, Inc.

• Mental Illness Intermediate Care Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Illness Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.