Provider Demographics
NPI:1487256749
Name:DAKOTA UNLIMITED, INC,
Entity type:Organization
Organization Name:DAKOTA UNLIMITED, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:HELGESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-423-3995
Mailing Address - Street 1:15953 BISCAYNE AVE W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-1601
Mailing Address - Country:US
Mailing Address - Phone:651-423-3995
Mailing Address - Fax:
Practice Address - Street 1:15953 BISCAYNE AVE W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-1601
Practice Address - Country:US
Practice Address - Phone:651-423-3995
Practice Address - Fax:651-423-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service