REM WOODVALE, INC. (NPI# 1417011263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417011263 |
| Entity Type | Organization |
| Organization Name | REM WOODVALE, INC. |
| Practice Address |
592 Adams Ave Nw Owatonna MN 55060-2288 |
| Mailing Address |
6600 France Ave S Suite 500 Edina MN 55435-1805 |
| Practice Telephone | 9529226776 |
| Practice Fax Number | 9529226885 |
| Mailing Telephone | 9529226776 |
| Mailing Fax Number | 9529226885 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-10-05 |
| Authorized Official Name | MR. PATRICK MASYGA (STATE DIRECTOR) |
| Authorized Official Telephone | 9529226776 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 830935-4-WS | MN | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386768703 | Rem Woodvale, Inc. | Community/Behavioral Health | 301 N Main St, Austin, MN 55912-3498 | 2007-03-19 |
| Street Address |
592 ADAMS AVE NW |
| City | OWATONNA |
| State | MN |
| Zip Code | 55060-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936480 | Lee Joseph Bakewell | Nurse Practitioner | 2200 Nw 26th St, Owatonna, Owatonna, MN 55060 | 2019-01-25 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1801326418 | Katharyn Kristin Stricklin | Registered Nurse | 1961 Premier Drive, Suite 340 Mankato, Mankato, MN 55060 | 2017-06-15 |
| 1134666753 | Holly Christianson | Social Worker | 2575 Harvest Lane Nw, Owatonna, MN 55060 | 2017-01-20 |
| 1346613031 | Birchwood Cottages | Assisted Living Facility | 1905 Austin Road, Owatonna, MN 55060 | 2015-11-04 |
| 1881080067 | Cory Michael Kopas | Chiropractor | 130 26th Street Nw, Owatonna, MN 55060 | 2015-04-14 |
| 1528456613 | Quality Home Health Care Inc. | Home Health | 201 East Front Street, Owatonna, MN 55060 | 2014-12-26 |
| 1194017624 | Amy Louise Haycraft | Nurse Practitioner | South Central Human Relations Center, 610 Florence Ave, Owatonna, MN 55060 | 2011-05-02 |
| 1710123971 | Rahn Optometry Inc | Optometrist | 1130 W. Frontage Rd, Owatonna, MN 55060 | 2008-12-18 |
| 1063616993 | Michael John Dickman | Dentist | 1414 S Oak Ave Suite Five, Owatonna, MN 55060 | 2007-06-13 |
| Find all providers in zip 55060 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093938672 | Kaplan Woods Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 285 Cedardale Dr Se, Owatonna, MN 55060 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184244527 | Kam Homecare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1500 Nicollet Ave Apt 305, Minneapolis, MN 55403-2724 | 2020-04-24 |
| 1477117885 | Kelly Rae Martin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13881 Schuelke Beach Rd Nw, Miltona, MN 56354 | 2019-05-01 |
| 1295291573 | Tricia Bastian | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 607 4th St S, Walker, MN 56484-6400 | 2019-02-12 |
| 1881163632 | Jacob Wrich | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 603 3rd St W Apt 1, Hastings, MN 55033-1127 | 2018-11-21 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1154814564 | Laurie K. Tazelaar-williams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532 | 2018-06-11 |
| 1205340577 | Dale Conrad Forslin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1029 Highway 65 Ste 107, Braham, MN 55006-3360 | 2017-11-25 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| 1407396336 | Viko Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5651 69th Ave N, 203, Brooklyn Park, MN 55429-1579 | 2017-02-25 |
| 1972052702 | Marie-noel Hiol-hiol | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14642 Quartz Ter Nw, Ramsey, MN 55303-4581 | 2016-09-21 |
| 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.