OrganizationActive
Bright Lake Care LLC
NPI 1760203517 · Early Intervention Provider Agency · Minneapolis, MN
Provider details
- NPI number
- 1760203517
- Entity type
- Organization
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Organization subpart
- No
- Authorized official
- Tariq Ali, Owner(612) 800-4209
Specialties & taxonomies
Agencies
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3845 Hiawatha Ave Apt 509
Minneapolis, MN 55406-4454
Phone: (612) 800-4209
Street-level locationGet directions
Mailing address
3845 Hiawatha Ave Apt 509
Minneapolis, MN 55406-4454
Other names (DBA / former)
- Doing business as
- Bright Lake Care
- Doing business as
- Bright Lake Care
Registry dates
- Enumerated
- 2024-10-23
- Last updated
- 2025-05-13
- Certified
- 2025-05-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.