ANNANDALE INTENSIVE RESIDENTIAL TREATMENT – NPI #1831386275
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

ANNANDALE INTENSIVE RESIDENTIAL TREATMENT is a community based residential treatment facility located in ANNANDALE, MN. NPPES has assigned the NPI number 1831386275 to ANNANDALE INTENSIVE RESIDENTIAL TREATMENT on October 01, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ANNANDALE INTENSIVE RESIDENTIAL TREATMENT” is a dba name, the actual legal business name for this organization is CENTRAL MINNESOTA MENTAL HEALTH CENTER. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 17 years ago on Aug 05, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANNANDALE INTENSIVE RESIDENTIAL TREATMENT below.

NPI Profile for
CENTRAL MINNESOTA MENTAL HEALTH CENTER

NPI Number
1831386275
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTRAL MINNESOTA MENTAL HEALTH CENTER
Doing Business As (dba): ANNANDALE INTENSIVE RESIDENTIAL TREATMENT
Primary location
380 ANNANDALE BLVD
ANNANDALE, MN 55302
Phone: (320) 274-4050 Fax: (320) 274-4069
Mailing address
1321 13TH ST N
SAINT CLOUD, MN 56303-2613
Phone: (320) 252-5010 Fax: (320) 203-1855
Organization Subpart
No
Authorized Official
DAVID BARAGA
EXECUTIVE DIRECTOR
Phone: (320) 252-5010
Updated
Identifiers

Identifiers for ANNANDALE INTENSIVE RESIDENTIAL TREATMENT

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERDEPART OF HEALTH LICENSEMNFBL-0020515-25193
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
MN FBL-0020515-25193

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.