Awaken Recovery Center L.L.C

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

AWAKEN RECOVERY CENTER L.L.C

Practice address

400 Suite D 393 North Dunlap
St Paul, MN 55104

Phone

(763) 331-2162

NPI assigned

Sep 21, 2018

Organization subpart

Yes

Parent organization

AWAKEN RECOVERY CENTER L.L.CAs reported in NPPES

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

Authorized official

Name

Roderick Eugene Coleman

Title

Executive Director

Phone

(763) 331-2162

Specialties & licenses 1

Addresses

Part of

Awaken Recovery Center LLC

Locations

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1295219657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUITE D 393 NORTH DUNLAP",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "763-331-2162",
            "fax_number": "651-340-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUITE D 393 NORTH DUNLAP",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "763-331-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN RECOVERY CENTER L.L.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AWAKEN RECOVERY CENTER L.L.C",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "763-331-2162"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in St Paul, MN
• Providers in St Paul, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.