MIND REPOSE LLC – NPI #1609528272
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.

MIND REPOSE LLC is a substance abuse rehabilitation facility located in PASS CHRISTIAN, MS. NPPES has assigned the NPI number 1609528272 to MIND REPOSE LLC on January 25, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The NPI data also shows multiple names associated with this provider such as Blue Rose Detox Mansion and 2 other listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility. Keep in mind, having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

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 MIND REPOSE LLC below.

NPI Profile for
MIND REPOSE LLC

NPI Number
1609528272
Enumeration Date

(more than 4 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
MIND REPOSE LLC
Other name(s)
All associated names:
Other Name
Blue Rose Detox Mansion
Former Legal Business Name
Mind Repose LLC
Doing Business As (dba)
The Historic Blue Rose Recovery Mansion
Primary location
120 W SCENIC DR
PASS CHRISTIAN, MS 39571-4420
Phone: (480) 300-2655 Fax:
Mailing address
800 3RD AVE STE 1143
NEW YORK, NY 10022-7649
Phone: (480) 300-2655 Fax:
Organization Subpart
No
Authorized Official
DANIEL CASE
CEO
Phone: (480) 300-2655
Updated
Certification Date
Jan 25, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MIND REPOSE LLC

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
OTHERSTATE OF MISSISSIPPIMS1134710817
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.

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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
SharePoint
Endpoint type
SOAP URL
Endpoint Description
CLOSED SYSTEM
Content Type
CSV
Affiliation
N
Endpoint Location
120 W SCENIC DR,
PASS CHRISTIAN, MS 77025-1669