PCA POSITIVE DIRECTION (NPI# 1053563544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053563544 |
Entity Type | Organization |
Organization Name | PCA POSITIVE DIRECTION |
Practice Address |
810 Lawrence Pkwy Buffalo MN 55313-1045 |
Practice Telephone | 7636841610 |
Mailing Telephone | 7636841610 |
Enumeration Date | 2008-10-16 |
Last Update Date | 2008-10-16 |
Authorized Official Name | MR. PAUL M WERNER (PRESIDENT) |
Authorized Official Telephone | 7636841610 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | A225584700 | 05 |
Street Address |
810 LAWRENCE PKWY |
City | BUFFALO |
State | MN |
Zip Code | 55313-1045 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
1386279610 | Julie Lee | Pharmacist | 1300 Hwy 55, Buffalo, MN 55313 | 2020-03-06 |
1023510591 | Brenda Renee Bakken | Licensed Practical Nurse | 25 1st Ave Ne Suite 100, Buffalo, MN 55313 | 2018-03-01 |
1760938716 | Karen Kahler | Counselor | 1772 Donnelly Dr Nw, Buffalo, MN 55313 | 2016-08-30 |
1235514118 | Minnesota Teen Challenge, Inc. | Exclusive Provider Organization | 100 Garrison Ave Ne, Buffalo, MN 55313 | 2015-07-21 |
1912391723 | Cassandra Loeffler | Chiropractor | 1200 Mn 25, Buffalo, MN 55313 | 2015-03-19 |
1134531395 | Total Health and Wellness, Inc. | Chiropractor | 639 Ryan's Way, Buffalo, MN 55313 | 2014-05-22 |
1366797946 | Brenda Kay Lenz | Nurse Practitioner | 755 Crossroads Campus Dr Ne, Buffalo, MN 55313 | 2012-07-19 |
1801190327 | Professional Counseling Center | Community/Behavioral Health | 7 Highway 55 West, Unit 3, Wright One Plaza, Buffalo, MN 55313 | 2010-12-23 |
1619140456 | Lisa Marlene Marty | Speech-Language Pathologist | 2144 County Rd 12 South, Buffalo, MN 55313 | 2008-04-11 |
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Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184244527 | Kam Homecare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1500 Nicollet Ave Apt 305, Minneapolis, MN 55403-2724 | 2020-04-24 |
1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
1295291573 | Tricia Bastian | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 4th St S, Walker, MN 56484-6400 | 2019-02-12 |
1881163632 | Jacob Wrich | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 3rd St W Apt 1, Hastings, MN 55033-1127 | 2018-11-21 |
1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
1154814564 | Laurie K. Tazelaar-williams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532 | 2018-06-11 |
1205340577 | Dale Conrad Forslin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1029 Highway 65 Ste 107, Braham, MN 55006-3360 | 2017-11-25 |
1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
1407396336 | Viko Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5651 69th Ave N, 203, Brooklyn Park, MN 55429-1579 | 2017-02-25 |
1972052702 | Marie-noel Hiol-hiol | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14642 Quartz Ter Nw, Ramsey, MN 55303-4581 | 2016-09-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.