INTERLACHEN LODGE OPERATED BY INTERLODGE (NPI# 1427258599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427258599 |
| Entity Type | Organization |
| Organization Name | INTERLACHEN LODGE OPERATED BY INTERLODGE |
| Practice Address |
5141 William Ave Edina MN 55436-2126 |
| Mailing Address |
2419 Nicollet Ave Minneapolis MN 55404-3450 |
| Practice Telephone | 9527670360 |
| Practice Fax Number | 9529228892 |
| Mailing Telephone | 6128713320 |
| Mailing Fax Number | 6128710432 |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |
| Authorized Official Name | JOHN TREPP (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6128713320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 1044976 | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DEPT. OF HUMAN SERVICES - | 1044976 | 01 |
| Street Address |
5141 WILLIAM AVE |
| City | EDINA |
| State | MN |
| Zip Code | 55436-2126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326697277 | Nancy L. Dahlien | Technician | 5825 Tracy Avenue, Edina, MN 55436 | 2019-09-04 |
| 1194232033 | Kathryn Lagrave Reaney | Social Worker | 5050 Lincoln Dr Ste 350, Edina, MN 55436 | 2017-12-31 |
| 1417403296 | Lori Walker | Marriage & Family Therapist | 5780 Lincoln Drive, Suite 108, Edina, MN 55436 | 2016-08-31 |
| 1417374729 | Alisha Englund | Nurse Practitioner | 5901 Lincoln Drive, Cbc-ehs-2, Edina, MN 55436 | 2014-03-25 |
| 1669894887 | Orthodontic Care Specialists, Pllc | Dentist | 4980 W. 77th St., Edina, MN 55436 | 2014-01-07 |
| 1184976920 | Meisa Interpreting & Translation Services LLC. | Case Management | 5656 Lincoln Dr, Edina, MN 55436 | 2012-10-03 |
| 1730466996 | Gina Louise Smith Hughes | Dentist | 5101 Vernon Avenue South, Suite 1 B, Edina, MN 55436 | 2011-11-15 |
| 1669642864 | Diagnostic Imaging | Clinic/Center | 5021 Vernon Ave So, Suite 300, Edina, MN 55436 | 2008-03-04 |
| 1821266529 | Proreads | Clinic/Center | 5021 Vernon Ave S, Suite 300, Edina, MN 55436 | 2008-02-15 |
| 1386729978 | Rem Hennepin Inc | Intermediate Care Facility, Mentally Retarded | 5100 William Avenue, Edina, MN 55436 | 2006-10-25 |
| Find all providers in zip 55436 | ||||
| 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 |
|---|---|---|---|---|
| 1811245897 | Reihan Company | Community/Behavioral Health | 7455 France Ave S # 286, Edina, MN 55435-4702 | 2012-08-22 |
| 1043465321 | Heartland Health LLC | Community/Behavioral Health | 6950 France Ave S Ste 14, Edina, MN 55435-2016 | 2008-11-30 |
| 1134307689 | Connections Counseling and Recovery Services | Community/Behavioral Health | 6950 France Ave S Ste 204, Edina, MN 55435-2025 | 2008-02-07 |
| 1639797475 | Radiant Care LLC | Community/Behavioral Health | 5100 Edina Industrial Blvd Ste 236, Edina, MN 55439-3066 | 2020-07-08 |
| 1376948810 | Mental Health Systems | Community/Behavioral Health | 6600 France Ave S, Suite 230, Edina, MN 55435-1805 | 2014-10-27 |
| 1164864989 | Lrc Counseling, P.a. | Community/Behavioral Health | 6950 France Ave S, Suite 215, Edina, MN 55435-2008 | 2013-07-22 |
| 1962756122 | Barrett Counseling Services, LLC | Community/Behavioral Health | 7200 France Ave S, Suite 223, Edina, MN 55435-4300 | 2012-11-08 |
| 1326354432 | Cabot Psychological Services, Pllc | Community/Behavioral Health | 7400 Metro Blvd, Suite 216, Edina, MN 55439-2316 | 2010-08-26 |
| 1336460518 | Por, LLC | Community/Behavioral Health | 7380 France Ave S, Suite 209, Edina, MN 55435-4535 | 2010-06-22 |
| 1063641793 | Johnson Counseling Services LLC | Community/Behavioral Health | 7200 France Ave S Ste 224, Edina, MN 55435-4309 | 2009-07-02 |
| Find all providers in EDINA | ||||
Please comment or provide details below to improve the information on INTERLACHEN LODGE OPERATED BY INTERLODGE.
| 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.