TEMPORARY LIVING CENTER


Address: 7170 Bryant Lake Dr, Eden Prairie, MN 55344-3502
Phone: 9529426400

TEMPORARY LIVING CENTER (NPI# 1922275148) 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) 1922275148
Entity Type Organization
Organization Name TEMPORARY LIVING CENTER
Other Organization Name TLC
Practice Address 7170 Bryant Lake Dr
Eden Prairie
MN 55344-3502
Practice Telephone 9529426400
Mailing Telephone 9529426400
Enumeration Date 2008-05-15
Last Update Date 2008-05-15
Authorized Official Name MRS. JACQUE LEE ROBINSON-RICHARD (EXECUTIVE DIRECTOR)
Authorized Official Telephone 3373033536
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
1010423 MN Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MN MN ITS 2719550000 01

Other Provider/Organization Names

Other Name Type Code
TLC Doing Business As Name - Organization

Office Location

Street Address 7170 BRYANT LAKE DR
City EDEN PRAIRIE
State MN
Zip Code 55344-3502

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437384427 Kris Miller Counselor 7170 Bryant Lake Dr, Eden Prairie, MN 55344-3502 2009-05-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366000572 Hekima Care Inc. Case Management 8725 Columbine Rd Unit 46026, Eden Prairie, MN 55344 2019-06-03
1528537768 Smile Eden Prairie Dentist 6600 City W. Pkwy #315, Eden Prairie, MN 55344 2018-11-16
1215439781 Angelo Scherer Counselor 11010 Prairie Lakes Drive Suite 350, Eden Prairie, MN 55344 2018-03-01
1497272678 Matthew Lynn Occupational Therapist 431 Prairie Center Drive, Eden Prairie, MN 55344 2017-08-28
1184178956 Eric R Barrett Audiologist Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 2016-08-10
1609218676 Nations Care Link Nurse Practitioner 11000 Praire Lakes Dr, Suite 600, Eden Praire, MN 55344 2013-07-19
1497020390 Alixa Rx LLC Pharmacy 10132 West 76th St, Eden Prairie, MN 55344 2012-03-12
1831467331 Eagle Ridge Academy Local Education Agency (LEA) 7255 Flying Cloud Drive, Eden Prairie, MN 55344 2011-12-12
1205154739 Eden Prairie School District 272 Local Education Agency (LEA) 8100 School Road, Eden Prairie, MN 55344 2010-05-07
1992030613 Spinal Health Chiropractor 12100 Singletree Ln #129, Eden Prairie, MN 55344 2009-10-14
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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
1225202625 Redlake Chemical Health Program Group Home Substance Abuse Rehabilitation Facility 15797 Main Avenue, Redlake, MN 56671 2008-04-16
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 EDEN PRAIRIE
Zip Code 55344

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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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