Organization
WHITEMOUNTAIN LLC
Active
Other names
WhiteMountain llc
Organization subpart
No
Provider details
NPI number
Authorized official
TITILOPE AKANO (PRESIDENT)
(612) 251-2366
Entity
Organization
Contact information
Practice address
7133 116TH PL N, CHAMPLIN, MN 55316-2879
(612) 483-3771
Mailing address
7133 116TH PL N, CHAMPLIN, MN 55316-2879
(612) 483-3771
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/31/2023
Last updated
12/05/2024
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