Provider Demographics
NPI:1376230169
Name:1 ON 1 COMPREHENSIVE HEALTHCARE SOLUTION LLC
Entity Type:Organization
Organization Name:1 ON 1 COMPREHENSIVE HEALTHCARE SOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLU
Authorized Official - Middle Name:
Authorized Official - Last Name:DORLEH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:612-237-8725
Mailing Address - Street 1:14967 95TH PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-8537
Mailing Address - Country:US
Mailing Address - Phone:612-237-8725
Mailing Address - Fax:763-515-3351
Practice Address - Street 1:14967 95TH PL N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-8537
Practice Address - Country:US
Practice Address - Phone:612-237-8725
Practice Address - Fax:763-515-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service