Organization Active NPI

Alexandria Industries Family Health & Wellness Clinic

  • Primary Care Clinic/Center
  • Alexandria, MN
National Provider Identifier
1114471117
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ALEXANDRIA INDUSTRIES FAMILY HEALTH & WELLNESS CLINIC
Practice address
690 Voyager Dr
Suite 8
Alexandria, MN 56308-5295
Phone
(320) 335-2833
Fax
(320) 335-2469
NPI assigned
Aug 8, 2016
Last updated
Nov 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ACHIEVE WELLNESS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
Catherine Guilliams-Chan
Title
Chief Executive Officer
Phone
(715) 832-9467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

690 Voyager Dr
Suite 8
Alexandria, MN 56308-5295

Mailing address

690 Voyager Dr
Suite 8
Alexandria, MN 56308-5295
Phone (320) 335-2833

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
24D2115281Alexandria Industries Family Health &690 Voyager Drive, Alexandria, MN 56308Certificate of waiverJun 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Crystal Family Care Clinic5 organizations share this tax ID, including this one
Part of
Crystal Family Care Clinic

Other organizations with this tax ID 4

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

Locations

690 Voyager Dr
Ste 8
Alexandria, MN 56308
Phone (320) 335-2833

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1114471117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 VOYAGER DR",
            "address_2": "SUITE 8",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085295",
            "telephone_number": "320-335-2833",
            "fax_number": "320-335-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 VOYAGER DR",
            "address_2": "SUITE 8",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085295",
            "telephone_number": "320-335-2833",
            "fax_number": "320-335-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA INDUSTRIES FAMILY HEALTH & WELLNESS CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACHIEVE WELLNESS, LLC",
        "enumeration_date": "2016-08-08",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "GUILLIAMS-CHAN",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "715-832-9467"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.