NPIMap

Organization Active NPI

Rem Hennepin, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Minneapolis, MN
National Provider Identifier
1306912282
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
804409-2-WS Issued in MN
Legal business name
REM HENNEPIN, INC.
Practice address
6200 Shingle Creek Pkwy Ste 580
Minneapolis, MN 55430-2170
Phone
(763) 852-5325
NPI assigned
Nov 24, 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 and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 804409-2-WS MN Primary

Addresses

Primary practice location

6200 Shingle Creek Pkwy Ste 580
Minneapolis, MN 55430-2170

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
883313300MedicaidMN

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.

Locations

6040 Earle Brown Dr
Ste 305
Brooklyn Center, MN 55430

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1306912282",
    "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": "6200 SHINGLE CREEK PKWY STE 580",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554302170",
            "telephone_number": "763-852-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM HENNEPIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "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": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": "804409-2-WS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883313300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; 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.