Northwoods Dna, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

357493 Issued in MN

Legal business name

NORTHWOODS DNA, INC.

Practice address

2729 State 371 SW
Pine River, MN 56474-4025

Phone

(218) 587-3304

Fax

(218) 587-3314

NPI assigned

May 24, 2012

Organization subpart

No

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

Authorized official

Name

Melanie Burns

Title

Owner, Administrator

Phone

(218) 308-4334

Specialties & licenses 1

Addresses

Other names 1

• Brookside Doing business as

Locations

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1629338686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44526 COUNTY 3",
            "city": "BECIDA",
            "state": "MN",
            "postal_code": "566784437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2729 STATE 371 SW",
            "city": "PINE RIVER",
            "state": "MN",
            "postal_code": "564744025",
            "telephone_number": "218-587-3304",
            "fax_number": "218-587-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOODS DNA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER, ADMINISTRATOR",
        "authorized_official_telephone_number": "218-308-4334"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "357493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Hendrickson, LPCC
• Owen W. Johnson, DDS
• Jaelyn Elizabeth Kappes, PHARMD
• Lakes Area Pharmacy
• Michael S Marvin, O.D.
• Taylor Anne Ott, PHARMD
• Pine River Dental Arts, P.C.
• Pine River Dental Center LLC
• Pine River Dental Center LLC
• Pine River Eye Center, Inc.

• Assisted Living Facility in Pine River, MN
• Providers in Pine River, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.