NPIMap

Organization Active NPI

Child & Adolescent Behavioral Health Services

  • Psychiatric Hospital
  • Brainerd, MN
National Provider Identifier
1013042589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
CHILD & ADOLESCENT BEHAVIORAL HEALTH SERVICES
Practice address
11630 State Ave
Brainerd, MN 56401-7306
Phone
(218) 828-2201
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Doug Seiler
Title
Mental Health Admin Officer
Phone
(218) 739-7224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

11630 State Ave
Brainerd, MN 56401-7306

Mailing address

PO Box 64979
Saint Paul, MN 55164-0979
Phone (651) 431-3676

Other names 1

  • CABHS Brainerd Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Child Adolescent Behavioral Health Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

11630 State Ave
Brainerd, MN 56401
Phone (218) 828-2201

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013042589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64979",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551640979",
            "telephone_number": "651-431-3676",
            "fax_number": "651-431-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11630 STATE AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017306",
            "telephone_number": "218-828-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & ADOLESCENT BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEILER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "MENTAL HEALTH ADMIN OFFICER",
        "authorized_official_telephone_number": "218-739-7224"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CABHS Brainerd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.