NPIMap

Organization Active NPI

Catholic Charities of the Diocese of St. Cloud

  • Adult Mental Health Clinic/Center
  • Saint Cloud, MN
National Provider Identifier
1003944620
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CATHOLIC CHARITIES OF THE DIOCESE OF ST. CLOUD
Practice address
157 Roosevelt Rd
Suite 300
Saint Cloud, MN 56301-5478
Phone
(320) 240-3324
Fax
(320) 240-3339
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Judy Dillman
Title
Business Office Manager
Phone
(320) 650-1545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

157 Roosevelt Rd
Suite 300
Saint Cloud, MN 56301-5478

Mailing address

PO Box 2390
Saint Cloud, MN 56302-2390
Phone (320) 650-1550

Other identifiers 1

IdentifierTypeStateIssuer
936315701MedicaidMN

Other names 1

  • HOPE - WAIVERED Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000001 MN Part B Supplier - Clinic/Group Practice 0648165928 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Cloud, MN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of the Diocese of St Cloud17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

700 Cedar St
Ste 110
Alexandria, MN 56308
Phone (320) 763-3538

566 4th St NW
Elk River, MN 55330
Phone (320) 650-1660

208 W Broadway
Little Falls, MN 56345
Phone (320) 632-8243

808 3rd St SE
Ste 310
Little Falls, MN 56345
Phone (320) 632-4950

645 3rd Ave SE
Milaca, MN 56353
Phone (320) 650-1660

804 7th Ave S
Princeton, MN 55371
Phone (320) 650-1660

396 1st Ave S
Saint Cloud, MN 56301
Phone (320) 253-0736

305 7th Ave N
Saint Cloud, MN 56303
Phone (320) 252-4121

157 Roosevelt Rd
Ste 300
Saint Cloud, MN 56301
Phone (320) 240-3324

514 1st St SE
Wadena, MN 56482
Phone (218) 631-1593

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1003944620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2390",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563022390",
            "telephone_number": "320-650-1550",
            "fax_number": "320-650-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 ROOSEVELT RD",
            "address_2": "SUITE 300",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563015478",
            "telephone_number": "320-240-3324",
            "fax_number": "320-240-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES OF THE DIOCESE OF ST. CLOUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "DILLMAN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "320-650-1545"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "936315701",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOPE - WAIVERED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.