Rem - Southwest Services Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

8020913RS Issued in MN

Legal business name

REM - SOUTHWEST SERVICES INC

Practice address

585 Gravel Road
Montevideo, MN 56265

Phone

(952) 922-6776

Fax

(952) 922-6885

NPI assigned

Oct 25, 2006

Last updated

Mar 5, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brett Ian Cohen

Title

Coo

Phone

(800) 388-5150

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• REM Southwest Services Inc Montevideo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033294699. Details of each certification follow.

• CCN 24G282 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 24G282

Legal name

REM SW SERVICES (MONTEVIDEO)

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

May 1, 1983

Last certification

Jun 3, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

585 Gravel Road
Montevideo, MN 56265

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Rem Southwest Services Inc3 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.

• Rem Southwest Services, Inc.

  • Home Health Agency
  • Canby, MN
  • NPI 1538341649
  NPD tax ID
• Rem Southwest Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Canby, MN
  • NPI 1972678829
  NPD tax ID

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677974400000",
    "number": "1033294699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-922-6776",
            "fax_number": "952-922-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 GRAVEL ROAD",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "56265",
            "telephone_number": "952-922-6776",
            "fax_number": "952-922-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM - SOUTHWEST SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "8020913RS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108743600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REM Southwest Services Inc Montevideo",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "REM Southwest Services Inc Montevideo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Gretchen A Reeves, MA, SLP-CCC
• Thomas James Reeves Jr., DPT, ATC
• Faith Christine Richardson
• River Valley Anesthesia P.a.
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• Amy J Rongstad, F.N.P.
• Neal Craig Rucks, PAC

• Intellectual Disabilities Intermediate Care Facility in Montevideo, MN
• Providers in Montevideo, MN by specialty
• Intellectual Disabilities Intermediate Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.