CDC CENTERS, INC (NPI# 1285074922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285074922 |
| Entity Type | Organization |
| Organization Name | CDC CENTERS, INC |
| Other Organization Name | GLEN CREEK LODGE |
| Practice Address |
5708 Glen Ave Minnetonka MN 55345-6611 |
| Mailing Address |
14750 Lac Lavon Dr Burnsville MN 55306-6398 |
| Practice Telephone | 9528947722 |
| Practice Fax Number | 9528940882 |
| Mailing Telephone | 9528947722 |
| Mailing Fax Number | 9528940882 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-08-26 |
| Authorized Official Name | RUTH CAROL ACKLEY (CEO) |
| Authorized Official Telephone | 9528947722 |
| Authorized Official Credential | LADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 1066127 | MN | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Glen Creek Lodge | Doing Business As Name - Organization |
| Street Address |
5708 GLEN AVE |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55345-6611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417587205 | Pain Partners LLC | Pharmacist | 15225 Wild Wings Court, Minnetonka, MN 55345 | 2020-01-21 |
| 1356811608 | Caitlin Marie Peterson | Specialist/Technologist | 15708 Wood Knoll Lane, Minnetonka, MN 55345 | 2018-11-29 |
| 1649747007 | West Side Counseling LLC | Community/Behavioral Health | 10520 Wayzata Blvd., Suite 100, Minnetonka, MN 55345 | 2018-10-24 |
| 1689173247 | Theresa Tsuchiya | Psychologist | Relate, Inc., 5125 County Road 101, Suite 300, Minnetonka, MN 55345 | 2018-02-08 |
| 1497264147 | Minnetonka Assisted Living and Hospice | Community Health Worker | 14667 Lake Street Extension, Minnetonka, MN 55345 | 2017-09-26 |
| 1619494671 | Shree Revenue Management | Durable Medical Equipment & Medical Supplies | 6117, Creek Ridge Ct, Minnetonka, MN 55345 | 2017-08-29 |
| 1538606876 | Stefani Yanizeski | Speech-Language Pathologist | Minnesota Autism Center, 5710 Baker Road, Minnetonka, MN 55345 | 2017-01-25 |
| 1790157469 | Greg Anderson | Psychologist | 5125 County Road 101, #300, Relate, Inc., Minnetonka, MN 55345 | 2015-10-21 |
| 1861896375 | Kristine L Smith | Marriage & Family Therapist | 5125 County Road 101 Suite 300, Minnetonka, MN 55345 | 2014-10-13 |
| 1982014460 | Miranda Jean Johnson | Speech-Language Pathologist | 15265 Minnetonka Blvd., Minnetonka, MN 55345 | 2014-05-06 |
| Find all providers in zip 55345 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508383019 | Milestones Recovery Inc | Substance Abuse Rehabilitation Facility | 504 Plymouth Rd, Minnetonka, MN 55305-1045 | 2017-08-25 |
| 1023479706 | Counter Point Recovery | Substance Abuse Rehabilitation Facility | 5022 Baker Rd, Minnetonka, MN 55343 | 2016-03-09 |
| 1366866907 | West Side Sober Living | Substance Abuse Rehabilitation Facility | 12218 Lake Street Ext, Minnetonka, MN 55305-5172 | 2014-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1730791393 | Crecer Services | Substance Abuse Rehabilitation Facility | 220 Robert St S Ste 103, Saint Paul, MN 55107-1626 | 2020-08-17 |
| 1801405584 | Bridge Recovery LLC | Substance Abuse Rehabilitation Facility | 1485 10th Avenue Ne, Sauk Rapids, MN 56379-9838 | 2020-07-28 |
| 1710505821 | Rrecovery Services | Substance Abuse Rehabilitation Facility | 867 Pierce Butler Rte, Saint Paul, MN 55104-1522 | 2020-07-06 |
| 1912520966 | Avenues, LLC | Substance Abuse Rehabilitation Facility | 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 | 2020-05-26 |
| 1962022939 | Valley View Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 31591 64th Ave, Cannon Falls, MN 55009-4296 | 2020-04-20 |
| 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 | MINNETONKA |
| Zip Code | 55345 |
Please comment or provide details below to improve the information on CDC CENTERS, INC.
| 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.