EDGE HEALTH CARE AND MENTAL HEALTH SERVICES – NPI #1467201301
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 children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

EDGE HEALTH CARE AND MENTAL HEALTH SERVICES is a substance abuse rehabilitation facility located in SHOREVIEW, MN. NPPES has assigned the NPI number 1467201301 to EDGE HEALTH CARE AND MENTAL HEALTH SERVICES on May 14, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3245S0500X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Oct 21, 2024. 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 EDGE HEALTH CARE AND MENTAL HEALTH SERVICES below.

NPI Profile for
EDGE HEALTH CARE AND MENTAL HEALTH SERVICES

NPI Number
1467201301
Enumeration Date

(more than 2 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
EDGE HEALTH CARE AND MENTAL HEALTH SERVICES
Primary location
157 GRASS LAKE PL APT 309
SHOREVIEW, MN 55126-2063
Phone: (763) 498-4448 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
EKAN EKONG
PMHNP-BC
Phone: (763) 498-4448
Updated
Certification Date
Oct 21, 2024

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.

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
3245S0500X
- Substance Abuse Rehabilitation Facility / Substance Abuse Treatment, Children (Primary)
363LP0808X
- Nurse Practitioner / Psychiatric/Mental Health
363LG0600X
- Nurse Practitioner / Gerontology
3104A0625X
- Assisted Living Facility / Assisted Living, Mental Illness
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center)
251S00000X
- Community/Behavioral Health

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.