REM CENTRAL LAKES, INC. (NPI# 1831264290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831264290 |
| Entity Type | Organization |
| Organization Name | REM CENTRAL LAKES, INC. |
| Practice Address |
266 33rd Ave S Suite 10 Saint Cloud MN 56301-3786 |
| 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 | 2006-11-21 |
| Last Update Date | 2013-08-12 |
| Authorized Official Name | MR. PAT 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 | 1012250-2-WS | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 532513700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689974693 | Rem Central Lakes, Inc. | Assisted Living Facility | 200 8th St Se, Little Falls, MN 56345-3252 | 2010-10-25 |
| 1740304187 | Rem Central Lakes, Inc. | Community/Behavioral Health | 2700 1st St N Ste 103, Saint Cloud, MN 56303-4202 | 2007-03-19 |
| 1578744322 | Rem Central Lakes, Inc. | Community/Behavioral Health | 2700 1st St N, Suite 103, Saint Cloud, MN 56303-4256 | 2007-11-21 |
| Street Address |
266 33RD AVE S SUITE 10 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56301-3786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619046141 | Michael William Smith | Chiropractor | 266 33rd Ave S, Suite 7, Saint Cloud, MN 56301 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
| 1316453442 | Amber Grengs | Behavior Technician | 3721 23rd St S Ste 201, Saint Cloud, MN 56301 | 2017-12-27 |
| 1124532999 | Ashley Aune Lewandowski | Chiropractor | 3333 W. Division St. Suite 122a, St. Cloud, MN 56301 | 2017-11-30 |
| 1962923680 | Inspired By You Home Care, LLC | Home Health | 2700 1st Street N, Suite 202, St Cloud, MN 56301 | 2017-07-03 |
| 1487189569 | Brett Finberg | Pharmacy Technician | 141 33rd Ave South, Saint Cloud, MN 56301 | 2017-04-26 |
| 1629513221 | Robert Schug | Pharmacy Technician | 141 33rd Ave S, Saint Cloud, MN 56301 | 2017-01-05 |
| 1649726910 | Rebecca Hoffman Pllc | Specialist | 3400 1st Street N, Suite 300, St. Cloud, MN 56301 | 2016-08-28 |
| 1558728600 | Language Partners | Interpreter | 400 1st St S, Suite 600, St. Cloud, MN 56301 | 2016-01-20 |
| 1679981856 | Quality Homecare Services Inc | Home Health | 3450 W Germain St, Ste 206, St Cloud, MN 56301 | 2014-07-31 |
| 1063759546 | Grand St Paul Cvs, LLC | Durable Medical Equipment & Medical Supplies | 2420 Division St, St. Cloud, MN 56301 | 2013-01-03 |
| Find all providers in zip 56301 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | SAINT CLOUD |
| Zip Code | 56301 |
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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.