RANGE MENTAL HEALTH CENTER INC (NPI# 1851419345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851419345 |
| Entity Type | Organization |
| Organization Name | RANGE MENTAL HEALTH CENTER INC |
| Other Organization Name | DETOX |
| Practice Address |
626 S 13th St Virginia MN 55792 |
| Mailing Address |
624 S 13th St Virginia MN 55792 |
| Practice Telephone | 2187419120 |
| Practice Fax Number | 2187413170 |
| Mailing Telephone | 2187492881 |
| Mailing Fax Number | 2187493806 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2016-04-01 |
| Authorized Official Name | MARY J CARPENTER (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2187492881 |
| Authorized Official Credential | MSED, LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS BLUE SHIELD | 3L52RA | 01 |
| MN | MEDICA | 5042378 | 01 |
| Other Name | Type Code |
|---|---|
| Detox | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932368313 | Range Mental Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 731 3rd St S, Virginia, MN 55792 | 2008-06-02 |
| 1639232663 | Range Mental Health Center Inc | Substance Abuse Rehabilitation Facility | 3203 W 3rd Ave, Hibbing, MN 55746 | 2006-12-19 |
| 1346318193 | Range Mental Health Center Inc | Substance Abuse Rehabilitation Facility | 626 S 13th St, Virginia, MN 55792 | 2006-12-01 |
| Street Address |
626 S 13TH ST |
| City | VIRGINIA |
| State | MN |
| Zip Code | 55792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013018480 | Alan A Abraham | Counselor | 626 S 13th St, Detox Range Treatment Center, Virginia, MN 55792 | 2006-09-26 |
| 1346318193 | Range Mental Health Center Inc | Substance Abuse Rehabilitation Facility | 626 S 13th St, Virginia, MN 55792 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252983 | Teresa A Larrabee | Social Worker | 624 South 13th Street, Virginia, MN 55792 | 2018-04-20 |
| 1972874105 | Caryn M. Walters | Counselor | 504 1st St. S., Virginia, MN 55792 | 2012-01-19 |
| 1144502923 | Crystal Corrine Leal | Student in an Organized Health Care Education/Training Program | 624 S. 13th St., Virginia, MN 55792 | 2011-09-16 |
| 1417259110 | Ellen C. Taube | Pharmacist | 306 Chestnut, Virginia, MN 55792 | 2010-12-01 |
| 1518295567 | Virginia-gilbert Family Dental P.a | Dentist | 612-13th. St. So., Virginia, MN 55792 | 2009-12-03 |
| 1942442082 | Arrowhead Economic Opportunity Agency | In Home Supportive Care | 702 South Third Avenue, Virginia, MN 55792 | 2009-04-06 |
| 1609037324 | Stefan Leroy Kaiser | Preventive Medicine | 1101 9th St. N, Essentia Health Virginia Clinic, Virginia, MN 55792 | 2008-06-25 |
| 1457512915 | Duane Faccin Person | Legal Medicine | 910 6th St N, Duluth Clinic Virginia, Virginia, MN 55792 | 2008-06-18 |
| 1932368313 | Range Mental Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 731 3rd St S, Virginia, MN 55792 | 2008-06-02 |
| 1871634071 | Gary Frederick Miller | Social Worker | 624 S 13th Street, P O 1188, Virginia, MN 55792 | 2007-02-09 |
| Find all providers in zip 55792 | ||||
| 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 |
|---|---|---|---|---|
| 1346318193 | Range Mental Health Center Inc | Substance Abuse Rehabilitation Facility | 626 S 13th St, Virginia, MN 55792 | 2006-12-01 |
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| 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 |
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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.