NPIMap

Organization Active NPI

St. Croix Chippewa Indians of Wi

Doing business as Stctx

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Turtle Lake, WI
National Provider Identifier
1023729597
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ST. CROIX CHIPPEWA INDIANS OF WI
Doing business as
Stctx
Practice address
361 175TH Ave
Turtle Lake, WI 54889-9142
Phone
(715) 619-0015
NPI assigned
Dec 6, 2022
Last updated
Mar 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Todd Meinburg
Title
Executive Director
Phone
(715) 619-0015

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Substance Abuse Rehabilitation Facility 324500000X NU

Addresses

Primary practice location

361 175TH Ave
Turtle Lake, WI 54889-9142

Mailing address

361 175TH Ave
Turtle Lake, WI 54889-9142
Phone (715) 619-0015

Other names 1

  • STCTX Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Croix Tribal Council7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

361 175th Ave
Turtle Lake, WI 54889
Phone (715) 619-0015

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1023729597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 175TH AVE",
            "city": "TURTLE LAKE",
            "state": "WI",
            "postal_code": "548899142",
            "telephone_number": "715-619-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 175TH AVE",
            "city": "TURTLE LAKE",
            "state": "WI",
            "postal_code": "548899142",
            "telephone_number": "715-619-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX CHIPPEWA INDIANS OF WI",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "MEINBURG",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "715-619-0015"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STCTX",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STCTX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Turtle Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.