Twwmad LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TWWMAD LLC

Practice address

7111 Forthun Rd Ste 200
Baxter, MN 56425-8596

Phone

(218) 820-1516

NPI assigned

May 16, 2024

Organization subpart

No

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

Authorized official

Name

Shelly Hice

Title

Owner

Phone

(218) 330-6333

Specialties & licenses 1

Addresses

Other names 1

• Lifestyle Wellness Clinic Doing business as

Locations

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1508615980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 FORTHUN RD STE 200",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258596",
            "telephone_number": "218-820-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 FORTHUN RD STE 200",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258596",
            "telephone_number": "218-820-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWWMAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "HICE",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-330-6333"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestyle Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• True North Counseling and Consulting
• Kearra Trunde
• Bao Hoang Truong, DDS
• Shayna Lynn Tsinnie
• Jayden Taylor Tuorila, MHP
• David Matthew Ude, DDS
• Stephen Vagle, LMFT
• Heidi Van Eps, MASSAGE THERAPIST
• Emily Van Kampen, MS
• Madeline Rose Varland, DDS

• Clinic/Center in Baxter, MN
• Providers in Baxter, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.