Provider Demographics
NPI:1174795009
Name:ADENA LLC
Entity type:Organization
Organization Name:ADENA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BELISLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-328-1152
Mailing Address - Street 1:78 ST. CROIX TRAIL S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55043
Mailing Address - Country:US
Mailing Address - Phone:612-328-1152
Mailing Address - Fax:
Practice Address - Street 1:78 ST. CROIX TRAIL S
Practice Address - Street 2:SUITE 120
Practice Address - City:LAKELAND
Practice Address - State:MN
Practice Address - Zip Code:55043
Practice Address - Country:US
Practice Address - Phone:612-328-1152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health