RECOVERY WORKS/BC JAIL HOUSE PROGRAM (NPI# 1962671420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962671420 |
| Entity Type | Organization |
| Organization Name | RECOVERY WORKS/BC JAIL HOUSE PROGRAM |
| Other Organization Name | RECOVERY WORKS MINIMUM SECURITY PROGRAM |
| Practice Address |
640 Randolph Road Detroit Lakes MN 56502-0288 |
| Mailing Address |
640 Randolph Road Po Box 288 Detroit Lakes MN 56502-0288 |
| Practice Telephone | 2188446340 |
| Practice Fax Number | 2188441984 |
| Mailing Telephone | 2188446340 |
| Mailing Fax Number | 2188441984 |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MR. DARCY CALEB OLSON (TREATMENT DIRECTOR/COUNSELOR) |
| Authorized Official Telephone | 2188501984 |
| Authorized Official Credential | M.ED./L.A.D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1049659-1-CDT | MN | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Recovery Works Minimum Security Program | Other Name - Individual/Organization |
| Street Address |
640 RANDOLPH ROAD |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56502-0288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740627710 | Cynthia Kay Rastedt | Registered Nurse | 119 Graystone Plaza, Suite 110, Detroit Lakes, MN 56502 | 2013-05-30 |
| 1710206883 | Ryan Richard Manke | Dentist | 701 Highway 10 E, Detroit Lakes, MN 56502-0517 | 2010-05-27 |
| 1316009335 | Kristine M Riewer | Dentist | 701 Highway 10 E, Detroit Lakes, MN 56502-0517 | 2006-12-15 |
| 1386706307 | Donald L Steinmetz | Dentist | 701 Highway 10 E, Detroit Lakes, MN 56502-0517 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1275151896 | Integrative Therapies & Wellness | Occupational Therapist | 115 Willow St W Ste 4, Detroit Lakes, MN 56501-3922 | 2020-07-09 |
| 1083234959 | Angela D Horner | Counselor | 1301 Roosevelt Ave, Detroit Lakes, MN 56501-4407 | 2020-04-21 |
| 1972146041 | Robert Fairbanks | Non-emergency Medical Transport (VAN) | 1038 Campbell Ave, Detroit Lakes, MN 56501-3202 | 2019-10-22 |
| 1861033276 | Nina Marie Kleinschmidt | Pharmacy | 1315 Minnesota Ave, Detroit Lakes, MN 56501-3913 | 2019-10-07 |
| 1508325788 | Sonia Elisa Santoyo | Physical Therapist | Eh Home Care West-dl, 114 Frazee Street East, Detroit Lakes, MN 55601 | 2019-03-18 |
| 1215416896 | Cynthia Lou Gray | Occupational Therapist | Essentia Health St. Mary's Detroilakes, 1027 Washington Avenue, Detroit Lakes, MN 56501-3409 | 2018-08-14 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1003339573 | Sharon Lynn Bolar | Physician Assistant | 14490 E Fox Lake Rd, Detroit Lakes, MN 56501-7111 | 2017-07-17 |
| Find all providers in DETROIT LAKES | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083234959 | Angela D Horner | Counselor | 1301 Roosevelt Ave, Detroit Lakes, MN 56501-4407 | 2020-04-21 |
| 1699203232 | Ronald Charles Royer | Counselor | 811 8th St Se, Detroit Lakes, MN 56501-2842 | 2017-05-26 |
| 1699191767 | Timothy J Weeks | Counselor | 115 Willow St W Ste 1, Detroit Lakes, MN 56501-3922 | 2014-03-12 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1861497190 | Perl Corporation | Counselor | 1000 8th St Se, Detroit Lakes, MN 56501-2838 | 2005-06-14 |
| 1275132565 | Michael Keith Lachapelle | Counselor | 28579 Us Highway 10, Detroit Lakes, MN 56501-7308 | 2020-10-19 |
| 1114497609 | Krystal Marie Ramirez | Counselor | 28579 Us Highway 10, Detroit Lakes, MN 56501-7308 | 2018-11-28 |
| 1407367444 | Anderson Saint Georges | Counselor | 811 8th St Se, Detroit Lakes, MN 56501-2842 | 2017-10-17 |
| 1669864013 | Molly Sumers | Counselor | 28579 Us Highway 10, Detroit Lakes, MN 56501-7308 | 2015-02-23 |
| 1740617331 | Robert John Williams | Counselor | 115 Willow St W, Detroit Lakes, MN 56501-3922 | 2013-09-27 |
| Find all providers in DETROIT LAKES | ||||
| City | DETROIT LAKES |
| Zip Code | 56502 |
Please comment or provide details below to improve the information on RECOVERY WORKS/BC JAIL HOUSE PROGRAM.
| 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.