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Organization

ALL STAR ACADEMY (ASA)

Active
Other names
RICH CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATE UCHECHI ONYENEHO D.O.SPE.ED (PRESIDENT/CEO)
(952) 356-2953
Entity
Organization

Contact information

Practice address
11712 CARTIER AVE S, BURNSVILLE, MN 55337-3227
(952) 707-9684
(952) 707-9684
Mailing address
6000 BASS LAKE RD, SUITE 206, CRYSTAL, MN 55429-2700
(952) 356-2953

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
35664
MN
251B00000X
Case Management Agency
365664
MN
251E00000X
Home Health Agency
35664
MN
251S00000X
Community/Behavioral Health Agency
365664
MN
252Y00000X
Early Intervention Provider Agency
35664
MN
252Y00000X
Early Intervention Provider Agency
365664
MN
347C00000X
Private Vehicle
Primary
S389194616120
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
625
MN
Enumeration date
10/16/2013
Last updated
10/16/2013
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