METRO TREATMENT OF MINNESOTA, LP (NPI# 1902012107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902012107 |
| Entity Type | Organization |
| Organization Name | METRO TREATMENT OF MINNESOTA, LP |
| Other Organization Name | LAKE SUPERIOR TREATMENT CENTER |
| Practice Address |
14 E Central Entrance Suite B Duluth MN 55811-5508 |
| Mailing Address |
14050 Town Loop Blvd Suite 204 Orlando FL 32837-6190 |
| Practice Telephone | 2187860223 |
| Practice Fax Number | 2187860226 |
| Mailing Telephone | 4073517080 |
| Mailing Fax Number | 4073516930 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-11-29 |
| Authorized Official Name | DR. LARRY KACZMAREK (CONTROLLER) |
| Authorized Official Telephone | 4073517080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
261964-8 | MN | Suppliers |
| Y | 251S00000X | Community/Behavioral Health | 1008733-1-CDT | MN | Agencies |
| Other Name | Type Code |
|---|---|
| Lake Superior Treatment Center | Doing Business As Name - Organization |
| Street Address |
14 E CENTRAL ENTRANCE SUITE B |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-5508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205228145 | Bhg Xxxix, LLC | Clinic/Center | 14 E Central Entrance, Suite B, Duluth, MN 55811-5508 | 2015-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| 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 |
|---|---|---|---|---|
| 1760945745 | Community Circles, LLC | Community/Behavioral Health | 104 W Superior St # 200, Duluth, MN 55802-3000 | 2019-04-08 |
| 1083105894 | Superior Counseling | Community/Behavioral Health | 312 N Central Ave Ste 300, Duluth, MN 55807-2524 | 2018-05-29 |
| 1356852180 | Peace of Mind of Duluth, Inc. | Community/Behavioral Health | 1000 East 1st Street, Suite 100, Duluth, MN 55805 | 2017-10-19 |
| 1699206516 | Seeking Balance, LLC | Community/Behavioral Health | 205 W 2nd St Ste 301, Duluth, MN 55802-1928 | 2017-03-22 |
| 1023569928 | Living Hope Counseling & Coaching, LLC | Community/Behavioral Health | 230 W Superior St, Suite 400, Duluth, MN 55802-1916 | 2016-10-17 |
| 1568817138 | Fathers Rise Together | Community/Behavioral Health | 319 N 22nd Ave West, Duluth, MN 55807 | 2016-05-02 |
| 1124448493 | Sue Hall's Place To Grow LLC | Community/Behavioral Health | 6015 E Superior St, Duluth, MN 55804-2538 | 2014-04-24 |
| 1033536206 | Valencia C Ayers | Community/Behavioral Health | 1470 Boggs Rd Apt 1004, Duluth, GA 30096-5839 | 2014-03-25 |
| 1487918199 | Bridges To Success, Inc. | Community/Behavioral Health | 4402 Haines Rd, Duluth, MN 55811-1528 | 2012-06-27 |
| 1184995243 | Currahee Home Builders, Inc | Community/Behavioral Health | 2763 Meadow Church Rd, Suite 200, Duluth, GA 30097-4989 | 2012-01-21 |
| Find all providers in DULUTH | ||||
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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.