REDLAKE CHEMICAL HEALTH PROGRAM GROUP HOME


Address: 15797 Main Avenue, Redlake, MN 56671
Phone: 2186793995

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
REDLAKE GROUP HOME Doing Business As Name - Organization

Office Location

Street Address 15797 MAIN AVENUE
City REDLAKE
State MN
Zip Code 56671

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 3245S0500X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility
Specialization Substance Abuse Treatment, Children

Taxonomy Definition

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]

Providers in the same taxonomy and state

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
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Competitor

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City REDLAKE
Zip Code 56671

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Dataset Information

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.

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