MAHUBE-OTWA COMMUNITY ACTION PARTNERSHIP — NPI 1588939276 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in DETROIT LAKES, MN)

CMS-1500 Box 24J / 33a • NPI

1588939276

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QF0050X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

119 GRAYSTONE PLZ STE 110, DETROIT LAKES, MN, 56501-3034

✓ 9-Digit EDI 837 ZIP+4 (56501-3034)

Practice Phone & Referral Fax

(218) 847-1385

Fax: (218) 847-1388

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1588939276 (MAHUBE-OTWA COMMUNITY ACTION PARTNERSHIP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1588939276` (NPI-2 Organization / Facility)
Provider / Legal Name	MAHUBE-OTWA COMMUNITY ACTION PARTNERSHIP
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QF0050X` (Clinic/Center, Family Planning, Non-Surgical)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	119 GRAYSTONE PLZ STE 110, DETROIT LAKES, MN, 56501-3034
Practice Telephone / Fax	Tel: (218) 847-1385 \| Fax: (218) 847-1388
Administrative Mailing Address	1125 W RIVER RD, DETROIT LAKES, MN, 56501-2722
Enumeration & Last Sync	Enumerated: 2012-03-14 \| CMS Record Updated: 2025-07-31
Authorized Official	ELIZABETH KUOPPALA (Executive Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

119 GRAYSTONE PLZ STE 110, DETROIT LAKES, MN, 56501-3034

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Plain-English Taxonomy & CMS Crosswalk (261QF0050X)

What Does Taxonomy Code 261QF0050X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QF0050X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MAHUBE-OTWA COMMUNITY ACTION PARTNERSHIP)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QF0050X` — Clinic/Center, Family Planning, Non-Surgical Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: MN \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MAHUBE-OTWA COMMUNITY ACTION PARTNERSHIP (NPI #1588939276)