ST. JUDE RETREAT HOUSE, LLC (NPI# 1184943797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184943797 |
| Entity Type | Organization |
| Organization Name | ST. JUDE RETREAT HOUSE, LLC |
| Other Organization Name | ALPP INSTITUTE |
| Practice Address |
5875 Fleur Dr Des Moines IA 50321-2883 |
| Practice Telephone | 8009900340 |
| Practice Fax Number | 9542085770 |
| Mailing Telephone | 8009900340 |
| Mailing Fax Number | 9542085770 |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2016-12-16 |
| Authorized Official Name | MIKE VASQUEZ (CEO) |
| Authorized Official Telephone | 8009900340 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
01930 | IA | Allopathic & Osteopathic Physicians |
| N | 363L00000X | Nurse Practitioner | A054289 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 1340 | IA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0112726 | 05 |
| Other Name | Type Code |
|---|---|
| ALPP Institute | Other Name - Individual/Organization |
| Street Address |
5875 FLEUR DR |
| City | DES MOINES |
| State | IA |
| Zip Code | 50321-2883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750511143 | St Gregory Centers, Inc | Substance Abuse Rehabilitation Facility | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2009-07-20 |
| 1932697919 | Opioid Clinical Management, Inc. | Case Management | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2018-04-25 |
| 1518478916 | Anna Marie Bergida | Counselor | 5875 Fleur Dr, Des Moines, IA 50321 | 2017-10-12 |
| 1447760194 | Amanda Kristine Steward | Counselor | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2017-10-09 |
| 1578015749 | Stop Clinic LLC | Psychiatry & Neurology | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2016-11-03 |
| 1326445511 | St. Gregory Retreat Centers, LLC | Psychologist | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2014-12-03 |
| 1538566732 | St Jude Retreat House, LLC | Psychiatry & Neurology | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2014-12-03 |
| 1336484831 | St. Gregory Retreat Centers, LLC | Substance Abuse Rehabilitation Facility | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2012-12-10 |
| 1851699771 | Recovery Laboratory Services, Inc | Clinical Medical Laboratory | 5875 Fleur Dr, Suite 400, Des Moines, IA 50321-2883 | 2011-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780842864 | Allison Christine Carlson | Chiropractor | 4600 Park Ave, Des Moines, IA 50321-1237 | 2008-05-27 |
| 1588961668 | Carlson Chiropractic Pllc | Chiropractor | 4600 Park Ave, Des Moines, IA 50321-1237 | 2011-02-25 |
| 1164646691 | Sara Esther Sutton | Family Medicine | 3219 Sw 39th St, Des Moines, IA 50321-1304 | 2007-04-13 |
| 1750696852 | Community Neurorehab of Iowa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3000 Sw 37th St, Des Moines, IA 50321-1330 | 2010-08-12 |
| 1942714514 | Donald Joseph Anderson | Surgery | 3317 Southern Hills Dr, Des Moines, IA 50321-1434 | 2017-11-19 |
| 1235461286 | Thomas Patrick Reynolds | Counselor | 3615 Thornton Ave, Des Moines, IA 50321-1845 | 2010-02-02 |
| 1023210671 | Marwin E. Goff | Dentist | 3906 Wolcott Ave, Des Moines, IA 50321-1868 | 2007-06-05 |
| 1285986711 | Jordan Samuelson | Counselor | 4100 Wolcott Ave, Des Moines, IA 50321-1872 | 2012-10-08 |
| 1134426331 | Harbor View Medical | Physical Medicine & Rehabilitation | 6151 Thornton Ave., Suite 200, Des Moines, IA 50321-1900 | 2011-02-24 |
| 1639425184 | Elizabeth R Proctor | Speech-Language Pathologist | 3001 Thornton Ave, Des Moines, IA 50321-2020 | 2012-08-01 |
| Find all providers in zip 50321 | ||||
| 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 |
|---|---|---|---|---|
| 1346785524 | Big Change Medical | Substance Abuse Rehabilitation Facility | 26857 16th Ave S, Des Moines, WA 98198-9327 | 2016-12-27 |
| 1629525308 | St. Gregory Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 1985 Ne 51st Pl, Des Moines, IA 50313-2517 | 2016-09-09 |
| 1750511143 | St Gregory Centers, Inc | Substance Abuse Rehabilitation Facility | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2009-07-20 |
| 1871023416 | Bridges of Iowa | Substance Abuse Rehabilitation Facility | 1985 Ne 51st Pl, Des Moines, IA 50313-2517 | 2017-06-15 |
| 1447606272 | Franklin Family Practice Inc | Substance Abuse Rehabilitation Facility | 4908 Franklin Ave, Des Moines, IA 50310-1901 | 2016-05-11 |
| 1336484831 | St. Gregory Retreat Centers, LLC | Substance Abuse Rehabilitation Facility | 5875 Fleur Dr, Des Moines, IA 50321-2883 | 2012-12-10 |
| 1417200155 | House of Mercy | Substance Abuse Rehabilitation Facility | 1409 Clark St, Des Moines, IA 50314-1964 | 2012-10-18 |
| 1669695201 | House of Mercy | Substance Abuse Rehabilitation Facility | 1409 Clark St, Des Moines, IA 50314-1964 | 2007-04-11 |
| 1346362977 | House of Mercy | Substance Abuse Rehabilitation Facility | 1409 Clark St, Des Moines, IA 50314-1964 | 2007-04-04 |
| 1528116191 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 24215 Pacific Hwy S, Des Moines, WA 98198-4024 | 2007-01-08 |
| Find all providers in DES MOINES | ||||
| City | DES MOINES |
| Zip Code | 50321 |
Please comment or provide details below to improve the information on ST. JUDE RETREAT HOUSE, LLC.
| 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.