Erickson Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1080489-1-HCBS Issued in MN

Legal business name

ERICKSON CORPORATION

Doing business as

Erickson Home Care

Practice address

718 129TH Ave NE
Blaine, MN 55434-3250

Phone

(763) 222-6562

NPI assigned

Dec 23, 2016

Last updated

Dec 23, 2016By 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

Luke Erickson

Title

Owner

Phone

(763) 222-6562

Specialties & licenses 2

Addresses

Other names 1

• Erickson Home Care Doing business as

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482451200000",
    "number": "1437694734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 129TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 129TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343250",
            "telephone_number": "763-222-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICKSON CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-23",
        "last_updated": "2016-12-23",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-222-6562"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "MN",
            "license": "1080489-1-HCBS",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1080489-1-HCBS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Erickson Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Blaine, MN
• Providers in Blaine, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.