WEST SIDE SOBER LIVING (NPI# 1366866907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366866907 |
| Entity Type | Organization |
| Organization Name | WEST SIDE SOBER LIVING |
| Other Organization Name | DBA ONE TWELVE |
| Practice Address |
12218 Lake Street Ext Minnetonka MN 55305-5172 |
| Practice Telephone | 9525137475 |
| Mailing Telephone | 9525137475 |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2014-02-18 |
| Authorized Official Name | MR. MICHAEL CLIFTON HOLMES (OWNER) |
| Authorized Official Telephone | 9525137475 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 1066522 | MN | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| DBA One Twelve | Doing Business As Name - Organization |
| Street Address |
12218 LAKE STREET EXT |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55305-5172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
| 1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
| 1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
| 1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
| 1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
| 1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
| 1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
| 1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| Find all providers in zip 55305 | ||||
| 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 |
|---|---|---|---|---|
| 1508383019 | Milestones Recovery Inc | Substance Abuse Rehabilitation Facility | 504 Plymouth Rd, Minnetonka, MN 55305-1045 | 2017-08-25 |
| 1023479706 | Counter Point Recovery | Substance Abuse Rehabilitation Facility | 5022 Baker Rd, Minnetonka, MN 55343 | 2016-03-09 |
| 1285074922 | Cdc Centers, Inc | Substance Abuse Rehabilitation Facility | 5708 Glen Ave, Minnetonka, MN 55345-6611 | 2013-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1730791393 | Crecer Services | Substance Abuse Rehabilitation Facility | 220 Robert St S Ste 103, Saint Paul, MN 55107-1626 | 2020-08-17 |
| 1801405584 | Bridge Recovery LLC | Substance Abuse Rehabilitation Facility | 1485 10th Avenue Ne, Sauk Rapids, MN 56379-9838 | 2020-07-28 |
| 1710505821 | Rrecovery Services | Substance Abuse Rehabilitation Facility | 867 Pierce Butler Rte, Saint Paul, MN 55104-1522 | 2020-07-06 |
| 1912520966 | Avenues, LLC | Substance Abuse Rehabilitation Facility | 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 | 2020-05-26 |
| 1962022939 | Valley View Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 31591 64th Ave, Cannon Falls, MN 55009-4296 | 2020-04-20 |
| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1386277622 | Community of Recovering People | Substance Abuse Rehabilitation Facility | 1221 Wayzata Blvd E, Wayzata, MN 55391-1942 | 2020-02-14 |
| 1992366645 | One Touch of Christ Evangelistic Ministries | Substance Abuse Rehabilitation Facility | 5701 Shingle Creek Pkwy Ste 650, Brooklyn Center, MN 55430-2492 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | MINNETONKA |
| Zip Code | 55305 |
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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.