Sober Living Connection

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SOBER LIVING CONNECTION

Doing business as

One Twelve

Practice address

11115 Minnetonka Blvd
Hopkins, MN 55305

Phone

(952) 529-8849

Fax

(952) 426-3266

NPI assigned

Sep 30, 2020

Organization subpart

No

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

Authorized official

Name

David Micheal Kascmar

Title

Owner

Phone

(952) 529-8849

Specialties & licenses 1

Addresses

Other names 1

• ONE TWELVE Doing business as

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1255948584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11115 MINNETONKA BLVD",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-529-8849",
            "fax_number": "952-426-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 MINNETONKA BLVD",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "55305",
            "telephone_number": "952-529-8849",
            "fax_number": "952-426-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER LIVING CONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "KASCMAR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-529-8849"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ONE TWELVE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Hopkins, MN
• Providers in Hopkins, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.