Provider Demographics
NPI:1679887244
Name:THE SALVATION ARMY
Entity Type:Organization
Organization Name:THE SALVATION ARMY
Other - Org Name:CARING PARTNERS ADULT DAY PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GOVERNMENT GRANTWRITER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:UTHKE-SCALETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED OFFICIAL
Authorized Official - Phone:651-746-3543
Mailing Address - Street 1:20 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-3706
Mailing Address - Country:US
Mailing Address - Phone:507-288-5191
Mailing Address - Fax:507-281-8348
Practice Address - Street 1:115 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-3700
Practice Address - Country:US
Practice Address - Phone:507-288-5191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SALVATION ARMY NORTHERN DIVISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-05
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN802185-2-ADC261QA0600X
347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA883015100Medicaid