Active NPI
Empowered Recovery Solutions 'Life After' Recovery Residence
- Lodging Provider
- Zimmerman, MN
National Provider Identifier
1245155100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lodging Provider
- Legal business name
- EMPOWERED RECOVERY SOLUTIONS 'LIFE AFTER' RECOVERY RESIDENCE
- Practice address
- 12714 Fremont Ave
Zimmerman, MN 55398-9406 - Phone
- (763) 732-2065
- NPI assigned
- Aug 11, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shannon Tabaka, SW
- Title
- Owner/Program Director
- Phone
- (763) 732-2065
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lodging Provider | 177F00000X | Primary |
Addresses
Primary practice location
12714 Fremont Ave
Zimmerman, MN 55398-9406
Mailing address
6314 Cedar Rd
Oak Park, MN 56357-8529
Phone (763) 732-2065
National Provider Directory
National Provider DirectoryLocations
12714 Fremont Ave
Zimmerman, MN 55398
Phone (763) 732-2065
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1786406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1786406400000",
"number": "1245155100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6314 CEDAR RD",
"city": "OAK PARK",
"state": "MN",
"postal_code": "563578529",
"telephone_number": "763-732-2065",
"fax_number": "763-732-2065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12714 FREMONT AVE",
"city": "ZIMMERMAN",
"state": "MN",
"postal_code": "553989406",
"telephone_number": "763-732-2065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMPOWERED RECOVERY SOLUTIONS 'LIFE AFTER' RECOVERY RESIDENCE",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-11",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A",
"authorized_official_last_name": "TABAKA",
"authorized_official_first_name": "SHANNON",
"authorized_official_title_or_position": "OWNER/PROGRAM DIRECTOR",
"authorized_official_telephone_number": "763-732-2065",
"authorized_official_credential": "SW"
},
"taxonomies": [
{
"code": "177F00000X",
"taxonomy_group": "",
"desc": "Lodging",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Zimmerman, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.