REM WOODVALE, INC. COTTONWOOD (NPI# 1336560333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336560333 |
| Entity Type | Organization |
| Organization Name | REM WOODVALE, INC. COTTONWOOD |
| Practice Address |
2311 9th Avenue Sw Austin MN 55912 |
| Mailing Address |
2311 9th Avenue South West Austin MN 55912 |
| Practice Telephone | 9529226776 |
| Practice Fax Number | 9529226885 |
| Mailing Telephone | 9529226776 |
| Mailing Fax Number | 9529226885 |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2014-09-18 |
| Authorized Official Name | MR. PAT MASYGA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9529226776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 369304 | 05 |
| Street Address |
2311 9TH AVENUE SW |
| City | AUSTIN |
| State | MN |
| Zip Code | 55912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710538152 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 313 2nd Ave Ne, Austin, MN 55912 | 2019-09-26 |
| 1669029831 | David Kuehn | Specialist/Technologist | 1508 Main St. N, Austin, MN 55912 | 2019-08-22 |
| 1841844396 | Heather A Peterson | Social Worker | 101 21st Street Se, Austin, MN 55912 | 2019-08-01 |
| 1477058287 | Gerard Academy | Counselor | 1101 28th St Ne, Austin, MN 55912 | 2018-03-26 |
| 1821518739 | Steven Register | Specialist/Technologist | 1803 2nd Ave Sw, Austin, MN 55912 | 2017-06-21 |
| 1366849259 | Kristen Ashley Templeton | Dentist | 800 1st Avenue Sw, Austin, MN 55912 | 2014-11-20 |
| 1780923458 | Kurt Baumgartner | Hearing Instrument Specialist | 507 1 St Nw, Austin, MN 55912 | 2013-01-31 |
| 1396059242 | Lorna Kay Siefke-harbor | Psychologist | 902 19th Ave Sw, Austin, MN 55912 | 2010-08-03 |
| 1972777068 | Stanley Brent Stutzman | Psychologist | 301 12 Place Nw, Austin, MN 55912 | 2008-04-18 |
| 1669641130 | Charlotte A Yunker | Specialist/Technologist | 64291 218th St, Austin, MN 55912 | 2008-02-28 |
| Find all providers in zip 55912 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235566076 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 6100 Blarwood Dr, Austin, TX 78745-3445 | 2013-10-10 |
| 1952738791 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 11403 Boothill Dr, Austin, TX 78748-1858 | 2013-10-10 |
| 1316374150 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 7906 Appomattox Dr, Austin, TX 78745-6902 | 2013-10-10 |
| 1336576172 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 3319 Grasshopper Dr, Austin, TX 78748-5629 | 2013-10-10 |
| 1154758324 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 10202 Brantley Cv, Austin, TX 78748-1207 | 2013-10-03 |
| 1508293770 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 7507 Whistlestop Dr, Austin, TX 78749-2826 | 2013-10-03 |
| 1598192767 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 1402 Salem Meadow Cir, Austin, TX 78745-2912 | 2013-10-03 |
| 1588974307 | D&s Residential Services Lp | Intermediate Care Facility, Mentally Retarded | 1122 S. Capital of Texas Hwy, Ste.350, Austin, TX 78746 | 2010-10-14 |
| 1417283326 | Brenda's Support Services | Intermediate Care Facility, Mentally Retarded | 814 Sheraton Ave, Austin, TX 78745-2044 | 2009-10-27 |
| 1043417165 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 8911 North Capital of Tx Hwy, Building 1, Suite 1300, Austin, TX 78759-7203 | 2007-07-02 |
| Find all providers in AUSTIN | ||||
Please comment or provide details below to improve the information on REM WOODVALE, INC. COTTONWOOD.
| 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.