Provider Demographics
NPI:1497186704
Name:ADULT DAY SERVICES, INC.
Entity Type:Organization
Organization Name:ADULT DAY SERVICES, INC.
Other - Org Name:WALKER ADULT DAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-751-1324
Mailing Address - Street 1:620 CARR LK RD SE
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601
Mailing Address - Country:US
Mailing Address - Phone:218-751-1324
Mailing Address - Fax:218-444-5324
Practice Address - Street 1:620 CARR LK RD SE
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601
Practice Address - Country:US
Practice Address - Phone:218-751-1324
Practice Address - Fax:218-444-5324
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADULT DAY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-12
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1022091-3-ADC261QA0600X
MN1054266-ADC302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA161653600Medicaid