MALISSA ANN COSTANZO OWNER
NPI 1003394479
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Forest Lake, MN
NPI Status: Active since July 30, 2018
Contact Information
844 8TH AVE SE
FOREST LAKE, MN
ZIP 55025
Phone: (651) 272-5608
- Individual
- Female
- Community Based Residential Treatment Fa...
About MALISSA COSTANZO
This page provides the complete NPI Profile along with additional information for Malissa Costanzo, a provider established in Forest Lake, Minnesota with a medical specialization in Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1003394479 assigned on July 2018. The practitioner's primary taxonomy code is 320900000X with license number 1094965-1-HCBS (MN). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1003394479
- Provider Name
- MALISSA ANN COSTANZO OWNER
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 844 8TH AVE SE FOREST LAKE, MN 55025
- Location Phone
- (651) 272-5608
- Mailing Address
- 844 8TH AVE SE FOREST LAKE, MN 55025
- Mailing Phone
- (651) 272-5608
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-30-2018
- Last Update Date
- 08-01-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320900000X
- Type
- Residential Treatment Facilities
- License No.
- 1094965-1-HCBS
- License State
- MN
- Taxonomy Description
- A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 253J00000X | Agencies | Foster Care Agency | 1094965-1-HCBS (MN) |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 3 | 9 | 4 | 4 | 7 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 6 | 9 | 8 | 4 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 6 + 9 + 8 + 4 + 1 + 4 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1003394479 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003394479, enumerated in the NPI registry as an "individual" on July 30, 2018
The provider is located at 844 8th Ave Se Forest Lake, Mn 55025 and the phone number is (651) 272-5608
The provider's speciality is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X
This NPI record was last updated on July 30, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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