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Contact Information

ISD 621
2101 14TH ST NW
NEW BRIGHTON, MN55112-1841
 Phone: 612-623-3363
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Delivered Meals

332U00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for ISD 621

NPI # 1811366388
LBN Legal business name ISD 621
Authorized official JOYCE ELLEFSON - (COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/15/2015
Last updated 09/15/2015 - About 11 years ago
Identifiers
MN Medicaid A506713800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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