Provider Demographics
NPI:1417250044
Name:NULINE SOLUTIONS
Entity Type:Organization
Organization Name:NULINE SOLUTIONS
Other - Org Name:ASSURED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-829-1251
Mailing Address - Street 1:206 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-9375
Mailing Address - Country:US
Mailing Address - Phone:952-829-1251
Mailing Address - Fax:952-314-1527
Practice Address - Street 1:206 MALLARD DR
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-9375
Practice Address - Country:US
Practice Address - Phone:952-829-1251
Practice Address - Fax:952-314-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN347653310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA103620000OtherMHCP UMPI