REDLAKE CHEMICAL HEALTH PROGRAM GROUP HOME (NPI# 1225202625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225202625 |
Entity Type | Organization |
Organization Name | REDLAKE CHEMICAL HEALTH PROGRAM GROUP HOME |
Other Organization Name | REDLAKE GROUP HOME |
Practice Address |
15797 Main Avenue Redlake MN 56671 |
Mailing Address |
Po Box 114 Redlake MN 56671-0114 |
Practice Telephone | 2186793995 |
Practice Fax Number | 2186793976 |
Mailing Telephone | 2186793995 |
Mailing Fax Number | 2186793976 |
Enumeration Date | 2008-04-16 |
Last Update Date | 2008-04-16 |
Authorized Official Name | SALENA BRANCHAUD (PROGRAM MANAGER) |
Authorized Official Telephone | 2186793995 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
Other Name | Type Code |
---|---|
REDLAKE GROUP HOME | Doing Business As Name - Organization |
Street Address |
15797 MAIN AVENUE |
City | REDLAKE |
State | MN |
Zip Code | 56671 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326212721 | Red Lake Chemical Health Treatment Center | Substance Abuse Rehabilitation Facility | 15797 Main Avenue, Redlake, MN 56671 | 2008-04-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063030419 | Red Lake Homeless Shelter Inc. | Case Management | 15855 Main Ave, Red Lake, MN 56671 | 2020-07-13 |
1376026153 | Children's Healing Center | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 25060 Hwy 1 East, Red Lake, MN 56671 | 2018-09-08 |
1003332057 | Red Lake Detention Outpatient | Substance Abuse Rehabilitation Facility | 25064 Highway 1 East, Red Lake, MN 56671 | 2017-08-21 |
1831642214 | Jennifer Franke | Pharmacist | 24760 Hospital Rd., Red Lake, MN 56671 | 2016-08-02 |
1538445978 | Hoaibac Nguyen | Pharmacist | 24760 Hospital Rd, Red Lake, MN 56671 | 2011-10-31 |
1639466048 | Red Lake Comprehensive Health Services | Dental Hygienist | 24809 Hospital Drive, Highway 1, Redlake, MN 56671 | 2011-07-06 |
1821391822 | Jill Christine Andersen | Physical Therapist | Hwy 1 Hospital Dr. Box 497, Red Lake, MN 56671 | 2010-12-13 |
1871802934 | Elizabeth Vivian Rose | Dentist | 24760 Hospital Dr., Red Lake, MN 56671 | 2010-10-06 |
1104029388 | Shannon Carl Nelson | General Acute Care Hospital | Highway 1 Box 497, Red Lake, MN 56671 | 2007-06-06 |
1194930040 | Emcare | Clinic/Center | Phs Indian Hospital Hwy 1 Po 497, Red Lake, MN 56671 | 2007-05-14 |
Find all providers in zip 56671 |
Taxonomy Code | 3245S0500X |
Grouping | Residential Treatment Facilities |
Classification | Substance Abuse Rehabilitation Facility |
Specialization | Substance Abuse Treatment, Children |
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780020925 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1572 Co Rd 134, St. Cloud, MN 56303-0346 | 2013-05-15 |
1558652925 | Tapestry | Substance Abuse Rehabilitation Facility | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-04-20 |
1841441854 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 39413 120th St Sw, East Grand Forks, MN 56721-9121 | 2008-10-08 |
1922275148 | Temporary Living Center | Substance Abuse Rehabilitation Facility | 7170 Bryant Lake Dr, Eden Prairie, MN 55344-3502 | 2008-05-15 |
1679750426 | Prairie Lakes Youth Programs Boys Group Home | Substance Abuse Rehabilitation Facility | 1013 Lakeland Dr Ne, Willmar, MN 56201-2114 | 2008-01-23 |
1124212873 | Jacy 2, LLC | Substance Abuse Rehabilitation Facility | 319 Csah #20, Litchfield, MN 55355 | 2007-09-05 |
1588855878 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 28579 Us Highway 10, Springhill Group Home, Detroit Lakes, MN 56501-7308 | 2007-08-05 |
1376733659 | Lutheran Social Service of Minnesota | Substance Abuse Rehabilitation Facility | 820 Eickhof Blvd, Kairos House, Crookston, MN 56716-2600 | 2007-08-01 |
1275731317 | Minnesota Correctional Facility -togo | Substance Abuse Rehabilitation Facility | 62741 County Road 551, Togo, MN 55723-4509 | 2007-07-10 |
1811193188 | Nexus | Substance Abuse Rehabilitation Facility | 100 Crosier Dr, Suite 1, Onamia, MN 56359-4512 | 2007-06-25 |
Find all providers with the same taxonomy |
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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.