Active NPI
Ebenezer Daybreak of St. Paul
- Adult Day Care Clinic/Center
- Saint Paul, MN
National Provider Identifier
1144933268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- EBENEZER DAYBREAK OF ST. PAUL
- Practice address
- 45 10TH St W Ste 3440
Saint Paul, MN 55102-1062 - Phone
- (651) 328-4889
- NPI assigned
- Jan 4, 2023
- Last updated
- Jan 4, 2023
- Organization subpart
- Yes
- Parent organization
- EBENEZER SOCIETY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Todd Willett
- Title
- Cfo Accounting
- Phone
- (612) 874-3493
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
45 10TH St W Ste 3440
Saint Paul, MN 55102-1062
Mailing address
45 10TH St W Ste 3440
Saint Paul, MN 55102-1062
Phone (651) 328-4889
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | tiffany.jones@fairview.org | Direct |
National Provider Directory
National Provider Directory- Tax ID family
- Ebenezer Home Care
- Part of
- Ebenezer Home Care
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Minneapolis, MN
- NPI 1174508873
-
- Home Health Agency
- Minneapolis, MN
- NPI 1356636344
Locations
45 10th St W
Ste 3440
Saint Paul, MN 55102
Phone (651) 328-4889
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672790400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1672790400000",
"number": "1144933268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 10TH ST W STE 3440",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021062",
"telephone_number": "651-328-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 10TH ST W STE 3440",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551021062",
"telephone_number": "651-328-4889"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EBENEZER DAYBREAK OF ST. PAUL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EBENEZER SOCIETY",
"enumeration_date": "2023-01-04",
"last_updated": "2023-01-04",
"certification_date": "2023-01-04",
"status": "A",
"authorized_official_last_name": "WILLETT",
"authorized_official_first_name": "TODD",
"authorized_official_title_or_position": "CFO ACCOUNTING",
"authorized_official_telephone_number": "612-874-3493"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "tiffany.jones@fairview.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "45 10th St W Ste 3440",
"city": "Saint Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551021062",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.