NPIMap

Organization Active NPI

Rem Hennepin Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Minneapolis, MN
National Provider Identifier
1255416830
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
10120482RS Issued in MN
Legal business name
REM HENNEPIN INC
Practice address
614 Queen Avenue South
Minneapolis, MN 55405
Phone
(952) 922-6776
Fax
(952) 922-6885
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 10120482RS MN Primary

Addresses

Primary practice location

614 Queen Avenue South
Minneapolis, MN 55405

Mailing address

6600 France Ave S
Edina, MN 55435-1805
Phone (952) 922-6776

Other identifiers 1

IdentifierTypeStateIssuer
639667400MedicaidMN

Other names 1

  • Rem Hennepin Inc Queen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 24G182

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
REM HENNEPIN INC QUEEN
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 1, 1976
Last certification
Oct 22, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
614 Queen Ave So
Minneapolis, MN 55405

National Provider Directory

National Provider Directory
Tax ID family
Rem Hennepin Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1255416830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-922-6776",
            "fax_number": "952-922-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 QUEEN AVENUE SOUTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55405",
            "telephone_number": "952-922-6776",
            "fax_number": "952-922-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM HENNEPIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "10120482RS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "639667400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rem Hennepin Inc Queen",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Rem Hennepin Inc Queen",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.