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Mr. Van Dyke Kofi Noah
Respite Care in Eagan, Minnesota
NPI 1619410412

Van Dyke Kofi Noah is a Respite Care based in Eagan, MN. Van Dyke Kofi Noah practices in Eagan, MN. The NPI Number for Van Dyke Kofi Noah is 1619410412 and holds a License No. 1083493-1-HCBS (Minnesota).

The current practice location address for Van Dyke Kofi Noah is 4836 Safari Pass, Eagan, MN and can be reached out via phone at 952-846-8047 and via fax at 651-452-2698. You can also correspond with Van Dyke Kofi Noah through the mailing address at 4836 SAFARI PASS, EAGAN, MN - 55122-2663 (mailing address contact number: 952-846-8047).

Location: 4836 Safari Pass, Eagan, MN, 55122-2663
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619410412
Provider Name
Van Dyke Kofi Noah
Credential
Provider Entity Type
Individual
Gender
Male
Address
4836 Safari Pass, Eagan, MN, 55122-2663
Phone Number
952-846-8047
Fax Number
651-452-2698
Provider Enumeration Date
11/28/2016
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1081688-1-AFC 01 MN ADULT FOSTER CARE
institution
Provider Business Practice Location Address Details
Address
4836 Safari Pass
City
Eagan
State
Minnesota
Zip
55122-2663
Phone Number
952-846-8047
Fax Number
651-452-2698
person
Provider Business Mailing Address Details
Address
4836 Safari Pass
City
Eagan
State
Minnesota
Zip
55122-2663
Phone Number
952-846-8047
Fax Number
651-452-2698
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Behavior Technician
Speciality
-
Taxonomy
106S00000X
License No.
1083493-1-HCBS ()
Definition
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
person
Provider's Taxonomy Details 2
Type
Respite Care Facility
Classification
Respite Care
Speciality
-
Taxonomy
385H00000X
License No.
1083493-1-HCBS (Minnesota)
Definition
Definition to come.
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