Elite Child Development Center Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

ELITE CHILD DEVELOPMENT CENTER INC

Practice address

3860 Molina St
Shakopee, MN 55379-5449

Phone

(612) 203-3147

NPI assigned

Sep 1, 2020

Organization subpart

No

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

Authorized official

Name

Hana F Dirie

Title

Owner

Phone

(952) 393-0559

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1528672243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 MOLINA ST",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 MOLINA ST",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553795449",
            "telephone_number": "612-203-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHILD DEVELOPMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "DIRIE",
        "authorized_official_first_name": "HANA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-393-0559"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Clayton Eckart, DDS
• Jason Eckerman, PSY.D., LP
• Brenna L Edgeworth
• Edina Eye Physicians and Surgeons PA
• Salena Ejuwa
• Elizabeth Root Ma, LMFT
• Kaitlin Emma Ellingsworth
• Erik Elsberry
• John Eugene Elvecrog, D.D.S
• Mark Joseph Elvecrog, D.D.S

• Developmental Disabilities Clinic/Center in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Developmental Disabilities Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.