RS Eden

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

10033342CDT Issued in MN

Legal business name

RS EDEN

Practice address

1025 Portland Ave
Minneapolis, MN 55404-1449

Phone

(612) 338-0723

Fax

(612) 338-3653

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Jessie Johnson

Title

Co-President and Ceo

Phone

(612) 287-1619

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Tax ID family

RS Eden Inc2 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.

• RS Eden Inc

  • Social Worker
  • Minneapolis, MN
  • NPI 1073737185
  NPD tax ID

Locations

Practitioners 8

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

• Callista Joanne Stephens, MA, LPCC, LADC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1124734637
  NPD
• Shamini Ruwanthika Abeykooon, BS

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1619677549
  NPD (past)
• Zachary Bodeau, LPCC, MA

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1609669605
  NPD (past)
• Jilleen Dauth, LPCC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1992428106
  NPD (past)
• Amanda Goodwin, LPCC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1386437804
  NPD (past)
• Bisharo Hirsi

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1386344455
  NPD (past)
• Ellen Faye Samuelson, MA

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1144920190
  NPD (past)
• Armeda Wojciak, PHD

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1710666706
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1063590214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 W BROADWAY AVE",
            "address_2": "SUITE 101",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112400",
            "telephone_number": "612-287-1600",
            "fax_number": "612-287-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041449",
            "telephone_number": "612-338-0723",
            "fax_number": "612-338-3653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4527 Hiawatha Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554064492",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "818 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151418",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 7th St W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551024255",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551023601",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "444 Lynnhurst Ave W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043407",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "532 Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022008",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2310 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554043739",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2728 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071013",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 E 16th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041987",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3210 Lyndale Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554122563",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3218 Lyndale Ave N",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554122559",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1828 Central Ave NE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554184541",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1829 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041812",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1362 7th St W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551024206",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "357 Oneida St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551023642",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "822 S 3rd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151200",
            "country_code": "US",
            "telephone_number": "612-217-1667",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "614 E Grant St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554041431",
            "country_code": "US",
            "telephone_number": "612-338-0723",
            "fax_number": "612-338-3653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1931 W Broadway Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554112469",
            "country_code": "US",
            "telephone_number": "612-287-1600",
            "fax_number": "612-287-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RS EDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CO-PRESIDENT AND CEO",
        "authorized_official_telephone_number": "612-287-1619"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "10033342CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "682608300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Cyrilla Royce, LICSW
• Kathryn Nichols Royea, PA-C
• Ceanna Renee Royster
• Elizabeth Ann Royster, LMFT
• Hilary Royston, MD
• RS Eden Inc
• RSMN PC
• Chengying Ruan, DNP
• Kally Marie Rubash, PHARMD, RPH
• Kolin Rubel, MD

• Substance Abuse Rehabilitation Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.