NPIMap

Organization Active NPI

Twin Cities Behavioral Health PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Buffalo, MN
National Provider Identifier
1013311802
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1074289 Issued in MN
Legal business name
TWIN CITIES BEHAVIORAL HEALTH PC
Practice address
2 Division St E Ste 103
Buffalo, MN 55313-1774
Phone
(612) 998-5669
NPI assigned
Oct 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Authorized official

Name
Joseph Shagalow, LPNPI 1164520284
Title
Owner
Phone
(612) 998-5669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1074289 MN Primary

Addresses

Primary practice location

2 Division St E Ste 103
Buffalo, MN 55313-1774

Mailing address

8120 Penn Ave S Ste 554
Bloomington, MN 55431-1333
Phone (612) 998-5669

National Provider Directory

National Provider Directory
Tax ID family
Twin Cities Behavioral Health PC3 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

8120 Penn Ave S
Ste 554
Minneapolis, MN 55431
Phone (952) 831-3662

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1013311802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S STE 554",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311333",
            "telephone_number": "612-998-5669",
            "fax_number": "952-831-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DIVISION ST E STE 103",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131774",
            "telephone_number": "612-998-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES BEHAVIORAL HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "SHAGALOW",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-998-5669",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1074289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.