NPIMap

Organization Active NPI

CDC Centers

  • Addiction (Substance Use Disorder) Counselor
  • Burnsville, MN
National Provider Identifier
1215040605
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
8021411-CDT Issued in MN
Legal business name
CDC CENTERS
Practice address
1510 E 122ND St
Burnsville, MN 55337-6804
Phone
(952) 894-7722
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Darlene M Hart
Title
Ar Manager
Phone
(952) 894-7722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 8021411-CDT MN Primary

Addresses

Primary practice location

1510 E 122ND St
Burnsville, MN 55337-6804

Mailing address

1510 E 122ND St
Burnsville, MN 55337-6804
Phone (952) 894-7722

Other names 1

  • RIVER RIDGE TREATMENT CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CDC Centers4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1510 E 122nd St
Burnsville, MN 55337

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215040605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 E 122ND ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376804",
            "telephone_number": "952-894-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E 122ND ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376804",
            "telephone_number": "952-894-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDC CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AR MANAGER",
        "authorized_official_telephone_number": "952-894-7722",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "8021411-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVER RIDGE TREATMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.