NPIMap

Organization Active NPI

Alliance Clinic, LLC

  • Case Management Agency
  • Minneapolis, MN
National Provider Identifier
1881950285
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
303178 Issued in MN
Legal business name
ALLIANCE CLINIC, LLC
Practice address
3329 University Ave SE
Minneapolis, MN 55414-3325
Phone
(612) 454-2260
Fax
(612) 454-2340
NPI assigned
Apr 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Beryimar Haidibit Perozo-Trejo, BS, LADC
Title
Case Manager
Phone
(612) 454-2260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 303178 MN Primary

Addresses

Primary practice location

3329 University Ave SE
Minneapolis, MN 55414-3325

Mailing address

3329 University Avenue SE
Minneapolis, MN 55414
Phone (612) 454-2260

National Provider Directory

National Provider Directory

Locations

3329 University Ave SE
Minneapolis, MN 55414
Phone (612) 454-2260

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1881950285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 UNIVERSITY AVENUE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-454-2260",
            "fax_number": "612-454-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143325",
            "telephone_number": "612-454-2260",
            "fax_number": "612-454-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "PEROZO-TREJO",
        "authorized_official_first_name": "BERYIMAR",
        "authorized_official_middle_name": "HAIDIBIT",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "612-454-2260",
        "authorized_official_credential": "BS, LADC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MN",
            "license": "303178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.