PARK AVENUE CENTER MENTAL HEALTH SERVICES (NPI# 1174940076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174940076 |
| Entity Type | Organization |
| Organization Name | PARK AVENUE CENTER MENTAL HEALTH SERVICES |
| Practice Address |
2649 Park Ave Minneapolis MN 55407-1006 |
| Mailing Address |
2525 Park Ave Minneapolis MN 55404-4404 |
| Practice Telephone | 6128717443 |
| Mailing Telephone | 6128717443 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |
| Authorized Official Name | MARK CASAGRANDE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6128717443 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 801867-3-CDT | MN | Residential Treatment Facilities |
| Street Address |
2649 PARK AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55407-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124080742 | Vessela M Kouneva | Marriage & Family Therapist | 2649 Park Ave, Minneapolis, MN 55407 | 2006-04-06 |
| 1275880809 | Kelley Ann Sehman | Counselor | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2012-08-14 |
| 1821386988 | Joan Whiton | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2011-07-11 |
| 1588959134 | Wendy L Mathiason | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2011-06-11 |
| 1396045225 | Karin M Nystrom | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-10-26 |
| 1912226820 | Christin L Seirup | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-05-18 |
| 1891027454 | Jillian Marie Ellingson | Counselor | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2010-02-08 |
| 1568796613 | Timothy G Blake | Psychologist | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-09-22 |
| 1871722371 | Stephen Eugene Calvit | Social Worker | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-07-07 |
| 1801038989 | John Marshall Lampert | Marriage & Family Therapist | 2649 Park Ave, Minneapolis, MN 55407-1006 | 2009-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
| 1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
| 1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
| 1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
| 1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
| 1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
| 1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
| 1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
| Find all providers in zip 55407 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366913287 | Guided Pathway | Substance Abuse Rehabilitation Facility | 2119 Elliot Ave, Minneapolis, MN 55404-2971 | 2018-12-17 |
| 1407322217 | Mabs Recovery Center LLC | Substance Abuse Rehabilitation Facility | 5941 Washburn Ave S, Minneapolis, MN 55410-2848 | 2018-10-18 |
| 1063883411 | Life Refine Company, Inc. | Substance Abuse Rehabilitation Facility | 6901 78th Ave N Ste 106, Minneapolis, MN 55445-2720 | 2015-10-12 |
| 1336432087 | South East Homes Inc | Substance Abuse Rehabilitation Facility | 2732 Bloomington Ave, Minneapolis, MN 55407-1146 | 2011-05-26 |
| 1023314440 | Centre for African Immigrants Recovering From Drug and Alcohol Addicti | Substance Abuse Rehabilitation Facility | 5201 Bryant Ave N, Minneapolis, MN 55430-3588 | 2011-02-02 |
| 1932413887 | The Wayside House, Inc. | Substance Abuse Rehabilitation Facility | 2120 Clinton Ave S, Minneapolis, MN 55404 | 2010-08-03 |
| 1982831533 | Specialized Treatment Services, Inc. | Substance Abuse Rehabilitation Facility | 1132 Central Ave. Ne, Minneapolis, MN 55413-1512 | 2009-06-22 |
| 1548433840 | Victory Through Faith Recovery Services | Substance Abuse Rehabilitation Facility | 3047 5th Ave S, Minneapolis, MN 55408-2415 | 2008-04-08 |
| 1629296900 | Turning Point Incorporated | Substance Abuse Rehabilitation Facility | 1500 Golden Valley Road, Minneapolis, MN 55411 | 2007-04-23 |
| 1104950591 | Avalon Programs, LLC | Substance Abuse Rehabilitation Facility | 2800 University Ave Se, Suite 202, Minneapolis, MN 55414 | 2007-03-15 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55407 |
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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.