NPIMap

Organization Active NPI

Emily Program PC

  • Mental Illness Community Based Residential Treatment Facility
  • Saint Paul, MN
National Provider Identifier
1083906994
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
EMILY PROGRAM PC
Practice address
2230 Como Ave
Saint Paul, MN 55108-1720
Phone
(651) 645-5323
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Mr. Dirk A Miller, PHD, LP
Title
Executive Director
Phone
(651) 645-5323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2230 Como Ave
Saint Paul, MN 55108-1720

Mailing address

2265 Como Ave
Saint Paul, MN 55108-1737
Phone (651) 645-5323

Other names 1

  • The Emily Program Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2039881Emily Program Anna Westin House Adolescent & Young2230 Como Avenue, Saint Paul, MN 55108Certificate of waiverApr 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Emily Program P C9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

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": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1083906994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081737",
            "telephone_number": "651-645-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-645-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILY PROGRAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DIRK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "651-645-5323",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Emily Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Emily Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.