RUSTAD AUTISM THERAPY LLC (NPI# 1396984530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396984530 |
| Entity Type | Organization |
| Organization Name | RUSTAD AUTISM THERAPY LLC |
| Practice Address |
714 6th St Sw Rochester MN 55902-2904 |
| Practice Telephone | 6127081401 |
| Mailing Telephone | 6127081401 |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-12-08 |
| Authorized Official Name | MS. LISA A RUSTAD (OWNER) |
| Authorized Official Telephone | 6127081401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 252Y00000X | Early Intervention Provider Agency | MN | Agencies | |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
714 6TH ST SW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55902-2904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
| 1720584337 | John E Herman Home and Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 351 14th Ave Sw, Rochester, MN 55902 | 2018-04-03 |
| 1912442898 | Esperanza Torres | Dental Hygienist | 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 | 2016-12-30 |
| 1578971149 | Alduz Inri Surio Cabasa | Student in an Organized Health Care Education/Training Program | 609 1st Street Sw, Unit 102, Rochester, MN 55902 | 2014-07-28 |
| 1679901854 | Julie Erickson | Dental Hygienist | United Way Building Suite #208, Rochester, MN 55902 | 2013-10-24 |
| 1619313590 | Mercedes K Schulz | Dental Hygienist | 13394th Ave Sw, Rochester, MN 55902 | 2013-05-17 |
| 1093087389 | Sarah Jean Dennison | Clinic/Center | 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 | 2012-02-01 |
| 1467732156 | Angela Elizabeth Peters | Registered Nurse | 1450 2nd Avenue Sw, Rochester, MN 55902 | 2011-08-25 |
| 1528350071 | Emily Zahasky Kraft | Pharmacist | 204 1st Street Sw, Rochester, MN 55902 | 2011-05-03 |
| 1093021982 | Sherry Dawn Boutcher | Dental Hygienist | 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 | 2010-08-30 |
| Find all providers in zip 55902 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104439728 | Andrea Brennan Licensed Mental Health Counseling, Pllc | Community/Behavioral Health | 245 Old Meadow Dr, Rochester, NY 14626-3548 | 2020-08-24 |
| 1407475270 | Southwood Psychiatric Hospital, LLC | Community/Behavioral Health | 203-205 Brighton Avenue, Rochester, PA 15074-2161 | 2020-04-13 |
| 1104338284 | Nicole Monta Psychotherapy, Plc | Community/Behavioral Health | 900 W University Dr, Rochester, MI 48307-1817 | 2017-10-30 |
| 1942722079 | Phoenix Psychology Services, Pllc | Community/Behavioral Health | 423 3rd Ave Se Ste 201, Rochester, MN 55904-4897 | 2017-07-11 |
| 1689102246 | Families & Friends of The Mentally Ill | Community/Behavioral Health | 320 N Goodman St, Rochester, NY 14607-1185 | 2017-05-26 |
| 1790221992 | Victory Fitness | Community/Behavioral Health | 52 Depew St, Rochester, NY 14611-2403 | 2017-01-11 |
| 1336681428 | Exercise Express LLC | Community/Behavioral Health | 232 Plymouth Ave S, Rochester, NY 14608-2237 | 2016-11-07 |
| 1457730160 | Maria Nichols | Community/Behavioral Health | 200 Frank Dimino Way Apt 203, Rochester, NY 14624-1188 | 2015-05-27 |
| 1043615586 | Amar Wellness Services, LLC | Community/Behavioral Health | 6556 Clarkia Dr Nw, Rochester, MN 55901-0285 | 2014-10-27 |
| 1639590045 | Riverstone Psychological Services | Community/Behavioral Health | 511 Northern Hills Dr Ne, Suite 2, Rochester, MN 55906 | 2014-01-02 |
| Find all providers in ROCHESTER | ||||
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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.