NPIMap

Organization Active NPI

Avalon Programs, LLC

Doing business as Avalon - Prospect Park

  • Addiction (Substance Use Disorder) Counselor
  • Minneapolis, MN
National Provider Identifier
1104950591
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1016848 Issued in MN
Legal business name
AVALON PROGRAMS, LLC
Doing business as
Avalon - Prospect Park
Practice address
2800 University Ave SE
Suite 202
Minneapolis, MN 55414
Phone
(612) 638-2282
Fax
(612) 326-7642
NPI assigned
Mar 15, 2007
Last updated
Dec 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Paul Lindeman
Title
Director - Revenue Cycle MGMT
Phone
(612) 326-7566

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 1016848 MN Primary
Substance Abuse Rehabilitation Facility 324500000X 1016848-4-CDT MN

Addresses

Primary practice location

2800 University Ave SE
Suite 202
Minneapolis, MN 55414

Mailing address

550 Main St
Ste 230
New Brighton, MN 55112
Phone (612) 326-7600

Other names 1

  • Avalon - Prospect Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avalon Programs LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

2800 University Ave SE
Ste 202
Minneapolis, MN 55414
Phone (612) 638-2282

Practitioners & affiliated clinicians

Practitioners 1

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1104950591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST",
            "address_2": "STE 230",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-326-7600",
            "fax_number": "651-631-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 UNIVERSITY AVE SE",
            "address_2": "SUITE 202",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-638-2282",
            "fax_number": "612-326-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PROGRAMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "LINDEMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR - REVENUE CYCLE MGMT",
        "authorized_official_telephone_number": "612-326-7566"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1016848",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1016848-4-CDT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon - Prospect Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.