NPIMap

Organization Active NPI

Elite Services Center Inc

  • Community/Behavioral Health Agency
  • Blaine, MN
National Provider Identifier
1629798145
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ELITE SERVICES CENTER INC
Practice address
11005 Okinawa Ave
Blaine, MN 55449
Phone
(612) 298-2894
NPI assigned
Sep 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Ayan MohamedNPI 1164295697
Title
President
Phone
(612) 298-2894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

11005 Okinawa Ave
Blaine, MN 55449

Mailing address

11005 Okinawa Ave
Blaine, MN 55449
Phone (612) 298-2894

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1629798145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11005 OKINAWA AVE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "612-298-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11005 OKINAWA AVE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55449",
            "telephone_number": "612-298-2894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SERVICES CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "AYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-298-2894"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.