REM NORTH STAR, INC. (NPI# 1316012263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316012263 |
| Entity Type | Organization |
| Organization Name | REM NORTH STAR, INC. |
| Practice Address |
677 Anne St Nw Suite B Bemidji MN 56601-4390 |
| Mailing Address |
6600 France Ave S Suite 500 Edina MN 55435-1805 |
| Practice Telephone | 9529226776 |
| Practice Fax Number | 9529226885 |
| Mailing Telephone | 9529226776 |
| Mailing Fax Number | 9529226885 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2016-02-18 |
| Authorized Official Name | MR. PAT MASYGA (STATE DIRECTOR) |
| Authorized Official Telephone | 9529226776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 830534-2-WS | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 957815300 | 05 |
| Street Address |
677 ANNE ST NW SUITE B |
| City | BEMIDJI |
| State | MN |
| Zip Code | 56601-4390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376840694 | Holly A Graber | Physical Therapy Assistant | 677 Anne St Nw, Suite E, Bemidji, MN 56601-4390 | 2011-02-23 |
| 1487967402 | Deanne Marie Kivi | Occupational Therapist | 677 Anne St Nw, Bemidji, MN 56601-4390 | 2010-07-19 |
| 1063640647 | Andrea Lynn Brodina | Physical Therapist | 677 Anne St Nw, Bemidji, MN 56601-4390 | 2009-06-23 |
| 1932335288 | Donald Joseph Kapaun Jr. | Occupational Therapist | 677 Anne St Nw, Bemidji, MN 56601-4390 | 2009-06-01 |
| 1942443635 | Advantage Audiology & Hearing Healthcare, LLC | Audiologist-Hearing Aid Fitter | 677 Anne St Nw, Bemidji, MN 56601-4390 | 2009-04-12 |
| 1083874143 | Hazelton Family Dentistry, Pa | Clinic/Center | 677 Anne St Nw, Ste F, Bemidji, MN 56601-4390 | 2008-06-12 |
| 1184884231 | Zachary David Hazelton | Dentist | 677 Anne St Nw, Ste F, Bemidji, MN 56601-4390 | 2008-06-12 |
| 1518139120 | Speech Place LLC | Speech-Language Pathologist | 677 Anne St Nw, Suite E, Bemidji, MN 56601-4390 | 2008-03-24 |
| 1366635716 | Cheri Lynne Ware | Physical Therapist | 677 Anne St Nw, Bemidji, MN 56601-4390 | 2007-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1366093841 | Vickie Lynn Matthews | Technician | 1018 Miles Ave Se, Bemidji, MN 56601 | 2019-09-25 |
| 1518443530 | Lindsey Marie Whiting | Registered Nurse | 1300 Anne St, Bemidji, MN 56601 | 2018-07-12 |
| 1801257662 | Meghan Zigrida Paquette | Registered Nurse | 6055 161st Street Nw, Cass Lake, MN 56601 | 2016-03-08 |
| 1144686106 | Northwest Indian Oic | Home Health | 1819 Bemidji Ave N Ste 1, Bemidji, MN 56601 | 2016-01-06 |
| 1831560424 | Laura Hansen, Msw, Licsw Counseling Services, Inc. | Social Worker | 403 4th Street Ne, Suite 110, Bemidji, MN 56601 | 2015-10-08 |
| 1679949028 | Grand St. Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2312 Bemidji Ave North, Bemidji, MN 56601 | 2015-08-19 |
| 1255717617 | Mary S. Salter, Md Psc | Internal Medicine | 514 Beltrami Ave Nw Suite 102, Bemidji, MN 56601 | 2015-08-07 |
| 1225420615 | Cristin Evans | Counselor | 403 4th Street, Suite 300, Bemidji, MN 56601 | 2015-02-23 |
| 1619367919 | Angela Krom Fournier | Psychologist | 16150 Golden Eagle Court Nw, Eagle Vista Equine Center Inc., Bemidji, MN 56601 | 2015-01-26 |
| Find all providers in zip 56601 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184244527 | Kam Homecare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1500 Nicollet Ave Apt 305, Minneapolis, MN 55403-2724 | 2020-04-24 |
| 1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
| 1295291573 | Tricia Bastian | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 4th St S, Walker, MN 56484-6400 | 2019-02-12 |
| 1881163632 | Jacob Wrich | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 3rd St W Apt 1, Hastings, MN 55033-1127 | 2018-11-21 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1154814564 | Laurie K. Tazelaar-williams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532 | 2018-06-11 |
| 1205340577 | Dale Conrad Forslin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1029 Highway 65 Ste 107, Braham, MN 55006-3360 | 2017-11-25 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| 1407396336 | Viko Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5651 69th Ave N, 203, Brooklyn Park, MN 55429-1579 | 2017-02-25 |
| 1972052702 | Marie-noel Hiol-hiol | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14642 Quartz Ter Nw, Ramsey, MN 55303-4581 | 2016-09-21 |
| 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.