Minnesota Masonic Home Senior Outreach Services

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

802202 Issued in MN

Legal business name

MINNESOTA MASONIC HOME SENIOR OUTREACH SERVICES

Doing business as

CareBreak

Practice address

5430 Boone Ave N
New Hope, MN 55428-3615

Phone

(763) 592-3000

NPI assigned

Sep 19, 2005

Last updated

Aug 22, 2020By 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

Jon Lundberg

Title

Coo

Phone

(952) 948-7000

Specialties & licenses 1

Addresses

Other names 1

• CareBreak Doing business as

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396730131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 MASONIC HOME DR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554373661",
            "telephone_number": "952-948-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 BOONE AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283615",
            "telephone_number": "763-592-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA MASONIC HOME SENIOR OUTREACH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUNDBERG",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "952-948-7000"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MN",
            "license": "802202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareBreak",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristina Therese Melsen, M.S. CCC-SLP
• Meridian Chiropractic, Inc
• Lauren Meyer, OTD, OTR/L
• Rachel T Meyer, DDS
• Mindful Pathways LLC
• Minnesota Recovery Center L.L.C.
• Minnesota Rusco, Inc.
• Maida Kasim Mohamed
• Emma B Mohs
• Jaime Lea Monson, MSW, LICSW

• Adult Day Care Clinic/Center in New Hope, MN
• Providers in New Hope, 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 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.