Damascus Way

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

DAMASCUS WAY

Practice address

1515 E 66TH St
Richfield, MN 55423-2648

Phone

(763) 545-6558

Fax

(763) 275-9951

NPI assigned

Aug 21, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Tierre Webster, LGSW

Title

Executive Director

Phone

(612) 746-5631

Specialties & licenses 2

Addresses

Other names 1

• Damascus Way Reentry Center Other name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin P Callaghan, LICSW

  • Clinical Social Worker
  • Richfield, MN
  • NPI 1164290938
  NPD
• Jacob Charles Lusk, LPCC

  • Professional Counselor
  • New Brighton, MN
  • NPI 1235958646
  NPD

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1326822529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 OLSON MEMORIAL HWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554225016",
            "telephone_number": "763-545-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E 66TH ST",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232648",
            "telephone_number": "763-545-6558",
            "fax_number": "763-275-9951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 Olson Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554225016",
            "country_code": "US",
            "telephone_number": "763-545-6558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3253 Marschall Rd",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553793337",
            "country_code": "US",
            "telephone_number": "763-299-0808",
            "fax_number": "763-275-9951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2118 Campus Dr SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046492",
            "country_code": "US",
            "telephone_number": "507-292-1700",
            "fax_number": "763-275-9951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAMASCUS WAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "TIERRE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-746-5631",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damascus Way Reentry Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Rebecca M. Dahlberg, M.D.
• Ambiyo Dakane
• Kirsten Louise Daniels, AU.D.
• Mikaela J Daniels, PA-C
• Breana Lynn Daoust I
• Brooke Noelle Darst Rice, PT
• Sara Bernadette Dauphinais, PA-C

• Recovery Care Clinic/Center in Richfield, MN
• Providers in Richfield, MN by specialty
• Recovery Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.