Northeast House Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

801746-3RS Issued in MN

Legal business name

NORTHEAST HOUSE INC

Practice address

1918 19TH Ave NE
Minneapolis, MN 55418-4728

Phone

(612) 789-8841

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William L Everett, MA/QMRP/FAAMR

Title

Admin Assist/Program Dir

Phone

(612) 789-8841

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1962692905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 19TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554184728",
            "telephone_number": "612-789-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 19TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554184728",
            "telephone_number": "612-789-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMIN ASSIST/PROGRAM DIR",
        "authorized_official_telephone_number": "612-789-8841",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA/QMRP/FAAMR"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "801746-3RS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Art Therapy LLC
• Northeast Chiropractic PLLC
• Northeast Clinic PLLC
• Northeast College Prep
• Northeast Dental Wellness, PA
• Northeast Psychotherapy
• Northern Path Wellness LLC
• Northern Skies Counseling, LLC
• Northland Bus Service LLC
• Northland Corporation

• Intellectual Disabilities Intermediate Care Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Intellectual Disabilities Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.