MRS. RITA MARIE CANNONWOLF (NPI# 1093928459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093928459 |
| Entity Type | Individual |
| Full Name | MRS. RITA MARIE CANNONWOLF |
| Credential | B.A, T-ADC |
| Practice Address |
222 9th Ave W Alexandria MN 56308-2221 |
| Practice Telephone | 3207633912 |
| Practice Fax Number | 3207636629 |
| Mailing Telephone | 3207633912 |
| Mailing Fax Number | 3207636629 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | MN | Residential Treatment Facilities |
| Street Address |
222 9TH AVE W |
| City | ALEXANDRIA |
| State | MN |
| Zip Code | 56308-2221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104905272 | David Hedden Peterson | Social Worker | 222 9th Ave W, Alexandria, MN 56308-2221 | 2006-11-02 |
| 1033776737 | Kari Gritz | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2019-05-29 |
| 1124685862 | Kimberly Wilkins | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2019-05-28 |
| 1306305339 | Kandice Laray Gorres | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2019-03-19 |
| 1427576446 | Christopher Walter Anderson | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2017-08-30 |
| 1982125506 | James Robert Vener | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2017-07-05 |
| 1659727386 | Walter Alex Gribas | Social Worker | 222 9th Ave W, Alexandria, MN 56308-2221 | 2016-05-12 |
| 1164895124 | Thomas Hertzog | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2015-11-12 |
| 1548665573 | April Mia Vaniseghem | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2014-11-04 |
| 1578968277 | Michael Ray Klein | Counselor | 222 9th Ave W, Alexandria, MN 56308-2221 | 2014-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104836 | Center for Pain Management Ambulatory Surgery, Ltd | Pain Medicine | 804 23rd Street South, Sartell, MN 56308 | 2020-08-13 |
| 1548815590 | Ritajo Ellenberger | Licensed Practical Nurse | 220 Oak Street North, Alexandria, MN 56308 | 2019-08-06 |
| 1346808714 | Vance Thompson Vision Surgery Center Alexandria, Prof LLC | Clinic/Center | 2600 Jefferson St, Alexandria, MN 56308 | 2019-05-31 |
| 1811452048 | Little Falls Eye Care Center Pa | Optometrist | 2306 S. Broadway Str. Suite 12, Alexandria, MN 56308 | 2019-02-01 |
| 1184167199 | Jennifer Lynn Craig | Technician | 2307 East Golf Course Rd, Alexandria, MN 56308 | 2016-11-22 |
| 1548712219 | Shelby Elisha Johnsrud | Chiropractor | 303 West 22nd Ave, Ste 100, Alexandria, MN 56308 | 2016-10-28 |
| 1811347867 | Dustin Matthew Ditch | Dentist | 510 22nd Ave E Ste 702, Alexandria, MN 56308 | 2016-06-20 |
| 1639538051 | West Central Chiropractic & Wellness, LLC | Chiropractor | 123 3rd Ave. E, Suite 100, Alexandria, MN 56308 | 2016-02-12 |
| 1659736221 | Amanda Jean Dahlseng | Registered Nurse | 809 Elm Street, Suite 1200, Alexandria, MN 56308 | 2015-12-23 |
| 1518358886 | Benjamin G Wenzel | Marriage & Family Therapist | 512 30th Ave S, Ste 100, Alexandria, MN 56308 | 2015-02-09 |
| Find all providers in zip 56308 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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|---|---|---|---|---|
| 1730680752 | Re-entry Solutions | Substance Abuse Rehabilitation Facility | 1617 Branch St, Alexandria, LA 71301-4302 | 2018-02-25 |
| 1255682027 | Gonzalez Recovery Residences, Inc. | Substance Abuse Rehabilitation Facility | 1401 N Pickett St, Alexandria, VA 22304-1401 | 2012-09-20 |
| 1457657074 | Therapeutic Solutions Consulting | Substance Abuse Rehabilitation Facility | 5790 Dunster Ct Apt 373, Alexandria, VA 22311-5933 | 2011-01-28 |
| 1245318377 | Thrive Behavioral Network Iv, LLC | Substance Abuse Rehabilitation Facility | 222 9th Ave West, Alexandria, MN 56308-2204 | 2006-11-02 |
| 1629560479 | Sandra M Christophe | Substance Abuse Rehabilitation Facility | 1617 Branch St, Alexandria, LA 71301-4302 | 2018-06-06 |
| 1225101827 | New Visions Center | Substance Abuse Rehabilitation Facility | 222 9th Ave W, Alexandria, MN 56308-2221 | 2006-11-15 |
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| 1912520966 | Avenues, LLC | Substance Abuse Rehabilitation Facility | 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 | 2020-05-26 |
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| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1386277622 | Community of Recovering People | Substance Abuse Rehabilitation Facility | 1221 Wayzata Blvd E, Wayzata, MN 55391-1942 | 2020-02-14 |
| 1992366645 | One Touch of Christ Evangelistic Ministries | Substance Abuse Rehabilitation Facility | 5701 Shingle Creek Pkwy Ste 650, Brooklyn Center, MN 55430-2492 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | ALEXANDRIA |
| Zip Code | 56308 |
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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.