NPIMap

Organization Active NPI

New Life Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Woodstock, MN
National Provider Identifier
1043219728
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
801702-3-CDT Issued in MN
Legal business name
NEW LIFE TREATMENT CENTER
Practice address
130 Dakota St S
Woodstock, MN 56186-1037
Phone
(507) 777-4321
Fax
(507) 777-4284
NPI assigned
Jul 15, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Wes Van Essen
Title
Administrator
Phone
(507) 777-4321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1033814-1-DS MN
Substance Abuse Rehabilitation Facility 324500000X 801702-3-CDT MN Primary

Addresses

Primary practice location

130 Dakota St S
Woodstock, MN 56186-1037

Mailing address

130 Dakota St S
Woodstock, MN 56186-1037
Phone (507) 777-4321

National Provider Directory

National Provider Directory
Tax ID family
New Life Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

130 Dakota St S
Woodstock, MN 56186
Phone (507) 317-6956

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043219728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DAKOTA ST S",
            "city": "WOODSTOCK",
            "state": "MN",
            "postal_code": "561861037",
            "telephone_number": "507-777-4321",
            "fax_number": "507-777-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DAKOTA ST S",
            "city": "WOODSTOCK",
            "state": "MN",
            "postal_code": "561861037",
            "telephone_number": "507-777-4321",
            "fax_number": "507-777-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN ESSEN",
        "authorized_official_first_name": "WES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-777-4321",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1033814-1-DS",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "801702-3-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, 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.