Christine Professional Health Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HE0108404 Issued in MN

Legal business name

CHRISTINE PROFESSIONAL HEALTH CARE INC

Practice address

9970 Madison St NE
Blaine, MN 55434-4207

Phone

(763) 464-4072

Fax

(763) 784-9322

NPI assigned

Sep 7, 2008

Organization subpart

No

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

Authorized official

Name

Mike Osaro Ohenzuwa, M.A.

Title

Director

Phone

(763) 464-4072

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1220745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220745600000",
    "number": "1396993036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9970 MADISON ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344207",
            "telephone_number": "763-464-4072",
            "fax_number": "763-784-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9970 MADISON ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344207",
            "telephone_number": "763-464-4072",
            "fax_number": "763-784-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE PROFESSIONAL HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-07",
        "last_updated": "2008-09-07",
        "status": "A",
        "authorized_official_last_name": "OHENZUWA",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "OSARO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "763-464-4072",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "HE0108404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI MINNESOTA HEALTH CARE PROGRAM MHCP",
            "identifier": "A185457000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI MINNESOTA HEALTH CARE PROGRAM MHCP",
            "identifier": "A265455100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI MINNESOTA HEALTH CARE PROGRAM MHCP",
            "identifier": "A936637200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI MINNESOTA HEALTH CARE PROGRAMS",
            "identifier": "A562678200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2008; 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.