Organization
ELITE CHILD DEVELOPMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANA F DIRIE (OWNER)
(952) 393-0559
Entity
Organization
Contact information
Practice address
3860 MOLINA ST, SHAKOPEE, MN 55379-5449
(612) 203-3147
Mailing address
3860 MOLINA ST, SHAKOPEE, MN 55379-5449
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QM3000X
Medically Fragile Infants and Children Day Care
—
—
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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