CENTRAL MINNESOTA MENTAL HEALTH CENTER (NPI# 1225016306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225016306 |
| Entity Type | Organization |
| Organization Name | CENTRAL MINNESOTA MENTAL HEALTH CENTER |
| Other Organization Name | NORTHWAY INTENSIVE RESIDENTIAL TREATMENT |
| Practice Address |
1509 24th Ave N Saint Cloud MN 56303-1306 |
| Mailing Address |
1321 13th St N Saint Cloud MN 56303-2613 |
| Practice Telephone | 3202528648 |
| Practice Fax Number | 3205294909 |
| Mailing Telephone | 3202525010 |
| Mailing Fax Number | 3202031855 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2009-08-05 |
| Authorized Official Name | DR. DAVID J. BARAGA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3202525010 |
| Authorized Official Credential | PH.D., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 801767-1-RMI | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 640902400 | 05 |
| Other Name | Type Code |
|---|---|
| Northway Intensive Residential Treatment | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164934303 | Central Minnesota Mental Health Center | Counselor | 253 8th Street Nw, Suite A, Elk River, MN 55330-1780 | 2017-10-27 |
| 1831386275 | Central Minnesota Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 380 Annandale Blvd, Annandale, MN 55302 | 2007-10-01 |
| 1386766426 | Central Minnesota Mental Health Center | Counselor | 3220 8th Street North, Saint Cloud, MN 56303-3128 | 2007-04-06 |
| 1114048170 | Central Minnesota Mental Health Center | Counselor | 730 Dodge Ave Nw, Suite 101, Elk River, MN 55330-1926 | 2007-04-03 |
| 1831177195 | Central Minnesota Mental Health Center | Counselor | 1321 13th St N, Saint Cloud, MN 56303-2613 | 2006-01-06 |
| 1558782250 | Central Minnesota Mental Health Center | Community/Behavioral Health | 1321 13th St N, Saint Cloud, MN 56303-2613 | 2013-12-23 |
| 1053576546 | Central Minnesota Mental Health Center | Counselor | 3333 W Division St, Suite 219, Saint Cloud, MN 56301-4515 | 2008-07-23 |
| 1780890046 | Central Minnesota Mental Health Center | Counselor | 407 Washington St, Monticello, MN 55362-8815 | 2007-05-15 |
| 1942416268 | Central Minnesota Mental Health Center | Counselor | 407 Washington St, Monticello, MN 55362-8815 | 2007-05-15 |
| 1639384043 | Central Minnesota Mental Health Center | Counselor | 3333 W Division St, Suite 217, Saint Cloud, MN 56301-4515 | 2007-05-11 |
| Street Address |
1509 24TH AVE N |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649708983 | Alyshia Bills | Social Worker | 1509 24th Ave N, Saint Cloud, MN 56303-1306 | 2017-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497823181 | Angel Arms LLC Elaine Niehaus | Community Based Residential Treatment Facility, Mental Illness | 1228 10th Ave N, Saint Cloud, MN 56303-2707 | 2006-12-01 |
| 1295148872 | Toro12 LLC | Community Based Residential Treatment Facility, Mental Illness | 1117 Massachusetts Ave, Saint Cloud, FL 34769-3787 | 2014-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730796384 | Maisa Inc. | Community Based Residential Treatment Facility, Mental Illness | 1113 E Franklin Ave Ste 208c, Minneapolis, MN 55404-2977 | 2020-09-28 |
| 1043837560 | Journey of Hope Community Housing LLC | Community Based Residential Treatment Facility, Mental Illness | 761 Case Ave, Saint Paul, MN 55106-3705 | 2020-06-30 |
| 1366005696 | Armando Cavazos | Community Based Residential Treatment Facility, Mental Illness | 84 Wabasha St S Apt 330, Saint Paul, MN 55107-1856 | 2019-04-22 |
| 1205300969 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4835-4901 West Boradway Avenue, Crystal, MN 55429 | 2019-01-16 |
| 1871064840 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 300 8th Ave Ne, Minneapolis, MN 55413-2030 | 2018-12-17 |
| 1144791112 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5546 7th St Ne, Fridley, MN 55432-5556 | 2018-12-17 |
| 1053882027 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7701 Able St Ne, Spring Lake Park, MN 55432-2809 | 2018-12-17 |
| 1699246678 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1140 80th Ave Ne, Spring Lake Park, MN 55432-2039 | 2018-12-17 |
| 1962973933 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6134 Woody Ln Ne, Fridley, MN 55432-5844 | 2018-12-17 |
| 1780155754 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 500 Ironton St Ne, Fridley, MN 55432-1633 | 2018-12-17 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on CENTRAL MINNESOTA MENTAL HEALTH CENTER.
| 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.