CENTRAL MINNESOTA MENTAL HEALTH CENTER (NPI# 1831386275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831386275 |
| Entity Type | Organization |
| Organization Name | CENTRAL MINNESOTA MENTAL HEALTH CENTER |
| Other Organization Name | ANNANDALE INTENSIVE RESIDENTIAL TREATMENT |
| Practice Address |
380 Annandale Blvd Annandale MN 55302 |
| Mailing Address |
1321 13th St N Saint Cloud MN 56303-2613 |
| Practice Telephone | 3202744050 |
| Practice Fax Number | 3202744069 |
| Mailing Telephone | 3202525010 |
| Mailing Fax Number | 3202031855 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2009-08-05 |
| Authorized Official Name | DR. DAVID J. BARAGA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3202525010 |
| Authorized Official Credential | PH.D., LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | FBL-0020515-2519 | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DEPART OF HEALTH LICENSE | FBL-0020515-25193 | 01 |
| Other Name | Type Code |
|---|---|
| Annandale Intensive Residential Treatment | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164934303 | Central Minnesota Mental Health Center | Counselor | 253 8th Street Nw, Suite A, Elk River, MN 55330-1780 | 2017-10-27 |
| 1386766426 | Central Minnesota Mental Health Center | Counselor | 3220 8th Street North, Saint Cloud, MN 56303-3128 | 2007-04-06 |
| 1114048170 | Central Minnesota Mental Health Center | Counselor | 730 Dodge Ave Nw, Suite 101, Elk River, MN 55330-1926 | 2007-04-03 |
| 1225016306 | Central Minnesota Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 1509 24th Ave N, Saint Cloud, MN 56303-1306 | 2006-01-09 |
| 1831177195 | Central Minnesota Mental Health Center | Counselor | 1321 13th St N, Saint Cloud, MN 56303-2613 | 2006-01-06 |
| 1558782250 | Central Minnesota Mental Health Center | Community/Behavioral Health | 1321 13th St N, Saint Cloud, MN 56303-2613 | 2013-12-23 |
| 1053576546 | Central Minnesota Mental Health Center | Counselor | 3333 W Division St, Suite 219, Saint Cloud, MN 56301-4515 | 2008-07-23 |
| 1780890046 | Central Minnesota Mental Health Center | Counselor | 407 Washington St, Monticello, MN 55362-8815 | 2007-05-15 |
| 1942416268 | Central Minnesota Mental Health Center | Counselor | 407 Washington St, Monticello, MN 55362-8815 | 2007-05-15 |
| 1639384043 | Central Minnesota Mental Health Center | Counselor | 3333 W Division St, Suite 217, Saint Cloud, MN 56301-4515 | 2007-05-11 |
| Street Address |
380 ANNANDALE BLVD |
| City | ANNANDALE |
| State | MN |
| Zip Code | 55302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023236874 | Annandale Family and Sports Chiropractic | Chiropractor | 300 Park Street, Annandale, MN 55302 | 2007-04-24 |
| 1356409577 | Bruce Robert Karg | Dentist | 18 Oak Avenue North, Annandale, MN 55302 | 2006-12-04 |
| 1629148614 | Annandale Eye Clinic Inc | Optometrist | 500 Elm St E, Annandale, MN 55302 | 2006-11-08 |
| 1356431803 | Dawn Ramaley | Physician Assistant | 440 Elm Street, Annandale, MN 55302 | 2006-10-13 |
| 1225130487 | Community Behavioral Health Hospital-annandale | Psychiatric Hospital | 400 Annandale Blvd., Annandale, MN 55302 | 2006-09-01 |
| 1801848635 | Gwen A Stein | Psychiatry & Neurology | 400 Annandale Blvd, Annandale, MN 55302 | 2006-05-17 |
| 1487610440 | Christopher Paul Maier | Family Medicine | 440 Elm Street East, Annandale, MN 55302 | 2006-04-26 |
| 1689633653 | Jonathan Strohschein | Family Medicine | 440 Elm St. East, Annandale, MN 55302 | 2006-03-20 |
| 1720073695 | Mitchell Ralph Uecker | Chiropractor | 300 Park St E, Annandale, MN 55302 | 2005-09-15 |
| 1295100626 | Morris Dental Clinic, Pa | Dentist | 300 Park Street East, Annandale, MN 55302 | 2015-12-10 |
| Find all providers in zip 55302 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730796384 | Maisa Inc. | Community Based Residential Treatment Facility, Mental Illness | 1113 E Franklin Ave Ste 208c, Minneapolis, MN 55404-2977 | 2020-09-28 |
| 1043837560 | Journey of Hope Community Housing LLC | Community Based Residential Treatment Facility, Mental Illness | 761 Case Ave, Saint Paul, MN 55106-3705 | 2020-06-30 |
| 1366005696 | Armando Cavazos | Community Based Residential Treatment Facility, Mental Illness | 84 Wabasha St S Apt 330, Saint Paul, MN 55107-1856 | 2019-04-22 |
| 1205300969 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 4835-4901 West Boradway Avenue, Crystal, MN 55429 | 2019-01-16 |
| 1871064840 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 300 8th Ave Ne, Minneapolis, MN 55413-2030 | 2018-12-17 |
| 1144791112 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5546 7th St Ne, Fridley, MN 55432-5556 | 2018-12-17 |
| 1053882027 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7701 Able St Ne, Spring Lake Park, MN 55432-2809 | 2018-12-17 |
| 1699246678 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1140 80th Ave Ne, Spring Lake Park, MN 55432-2039 | 2018-12-17 |
| 1962973933 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6134 Woody Ln Ne, Fridley, MN 55432-5844 | 2018-12-17 |
| 1780155754 | Rescare Minnesota, Inc. | Community Based Residential Treatment Facility, Mental Illness | 500 Ironton St Ne, Fridley, MN 55432-1633 | 2018-12-17 |
| 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.