MINNESOTA SPECIALTY HEALTH SYSTEMS-WADENA (NPI# 1154626554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154626554 |
| Entity Type | Organization |
| Organization Name | MINNESOTA SPECIALTY HEALTH SYSTEMS-WADENA |
| Practice Address |
240 Shady Lane Dr Wadena MN 56482-3093 |
| Practice Telephone | 6514313691 |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |
| Authorized Official Name | LORI ZOOK (CONTROLLER) |
| Authorized Official Telephone | 6514313691 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 1058768-1-RMI | MN | Residential Treatment Facilities |
| Street Address |
240 SHADY LANE DR |
| City | WADENA |
| State | MN |
| Zip Code | 56482-3093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033633904 | Hadc Wadena, LLC | Assisted Living Facility | 110 Hemlock Ave. Nw, Wadena, MN 56482 | 2017-08-01 |
| 1457665986 | Jill M Wilkens | Physician Assistant | 4 Deerwood Ave, Wadena, MN 56482 | 2010-07-26 |
| 1053525931 | Gerald Henry Gammell | Psychiatry & Neurology | 240 Shady Lane Drive, Wadena, MN 56482 | 2007-05-09 |
| 1336286228 | Wayne Calvin Howard | Dentist | 122 Sw Colfax, Wadena, MN 56482 | 2007-01-31 |
| 1699839399 | Peter W Finke | Physical Therapist | 311jefferson St. North, Tri County Hosptial, Wadena, MN 56482 | 2006-12-20 |
| 1902874480 | Corey H Tabbert | Optometrist | 222 Se First Street, Wadena, MN 56482 | 2006-03-09 |
| 1447333547 | Woodland Dental Inc | Dentist | 206 1st St Se, Wadena, MN 56482 | 2006-10-23 |
| 1306948245 | Wendy Amanda Gravelle | Nurse Anesthetist, Certified Registered | 415 Jefferson St North, Wadena, MN 56482 | 2006-09-01 |
| 1255312013 | Alfredmy G Chessor | General Practice | 4 Deerwood Ave Nw, Wadena, MN 56482 | 2005-11-09 |
| 1902961048 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 100 Juniper Ave, Wadena, MN 56482-1041 | 2006-12-27 |
| Find all providers in zip 56482 | ||||
| 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.