Provider Demographics
NPI:1558761981
Name:NATALIS OUTCOMES, LLC
Entity Type:Organization
Organization Name:NATALIS OUTCOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OUTREACH AND INTAKE SER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOISTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-800-6500
Mailing Address - Street 1:1821 UNIVERSITY AVE W STE 155
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-2880
Mailing Address - Country:US
Mailing Address - Phone:612-800-6500
Mailing Address - Fax:612-800-6501
Practice Address - Street 1:1821 UNIVERSITY AVE W STE 155
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-2880
Practice Address - Country:US
Practice Address - Phone:612-800-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1788251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01B55NAOtherBLUE CROSS INTERNAL REFERENCE NUMBER