| Holland Center | |
|
10273 Yellow Circle Drive Minnetonka MN 55343 | |
| (952) 401-9359 | |
| (952) 401-9805 |
| Full Name | Holland Center |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 10273 Yellow Circle Drive, Minnetonka, Minnesota |
| Authorized Official Name and Position | Jennifer Larson (CEO/FOUNDER) |
| Authorized Official Contact | 9524019359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holland Center 10273 Yellow Circle Drive Minnetonka MN 55343 Ph: (952) 401-9359 | Holland Center 10273 Yellow Circle Drive Minnetonka MN 55343 Ph: (952) 401-9359 |
| NPI Number | 1467641555 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 01/07/2025 |
| Medicare PECOS PAC ID | 1759507882 |
|---|---|
| Medicare Enrollment ID | O20140728000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467641555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 251C00000X | Day Training, Developmentally Disabled Services | (* (Not Available)) | Primary |
| Provider Name | Keri A Derauf |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649678723 PECOS PAC ID: 4981990751 Enrollment ID: I20160902000033 |
| Provider Name | Brittany West |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467883223 PECOS PAC ID: 9234425984 Enrollment ID: I20160907001459 |
| Provider Name | Briana Hedge |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699310482 PECOS PAC ID: 4587092085 Enrollment ID: I20200316002495 |
| Provider Name | Jenna R Barbeln |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205475266 PECOS PAC ID: 7012328941 Enrollment ID: I20201130000010 |
| Provider Name | Kaitlyn R Shoults |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1982294443 PECOS PAC ID: 2567878812 Enrollment ID: I20210310002886 |
| Provider Name | Abigail Bloch |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427671023 PECOS PAC ID: 8729495833 Enrollment ID: I20210407000783 |
| Provider Name | Lauren Dyke |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558947572 PECOS PAC ID: 8729497318 Enrollment ID: I20210512000407 |
| Provider Name | Sara Folk |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1811522360 PECOS PAC ID: 4789093261 Enrollment ID: I20210513001291 |
| Provider Name | Haley M Cernohous |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558945170 PECOS PAC ID: 4587069604 Enrollment ID: I20210826002854 |
| Provider Name | Cassandra Hagen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275285819 PECOS PAC ID: 5395122501 Enrollment ID: I20220509002275 |
| Provider Name | Jennifer Haggerty |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1912787359 PECOS PAC ID: 5991154072 Enrollment ID: I20231214002237 |
| Provider Name | Paige Mann |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780464669 PECOS PAC ID: 3375992464 Enrollment ID: I20231214002582 |
| Provider Name | Jacob Quinton |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538806617 PECOS PAC ID: 9032568134 Enrollment ID: I20231214002870 |
| Provider Name | Janna C George |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528887890 PECOS PAC ID: 4789117045 Enrollment ID: I20241025001442 |
| Provider Name | Julia Demain |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376372706 PECOS PAC ID: 1658804794 Enrollment ID: I20241029001592 |
| Provider Name | Mollie A Baldus |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154141992 PECOS PAC ID: 1759815756 Enrollment ID: I20241113003660 |
| Provider Name | Cassidy Hall |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1972323715 PECOS PAC ID: 5991239998 Enrollment ID: I20241113003849 |
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