St. Gregory Retreat Centers, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1332 Issued in IA

Legal business name

ST. GREGORY RETREAT CENTERS, LLC

Practice address

5875 Fleur Dr
Des Moines, IA 50321-2883

Phone

(515) 298-7209

Fax

(631) 410-1394

NPI assigned

Dec 10, 2012

Organization subpart

No

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

Authorized official

Name

Michael J Vasquez

Title

Ceo

Phone

(515) 421-4065

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1336484831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 FLEUR DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503212883",
            "telephone_number": "515-298-7209",
            "fax_number": "631-410-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 FLEUR DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503212883",
            "telephone_number": "515-298-7209",
            "fax_number": "631-410-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. GREGORY RETREAT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-421-4065"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IA",
            "license": "1332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SS Therapy and Consulting
• St Gregory Centers, Inc
• St Jude Retreat House, LLC
• St. Gregory Recovery Center, LLC
• St. Gregory Retreat Centers, LLC
• St. Jude Retreat House, LLC
• Brynn Marie Stacken, DO
• Levi Garrett Stacken, DO
• Denise Stadter, MA
• Emmaline S Staecker

• Substance Abuse Rehabilitation Facility in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Substance Abuse Rehabilitation Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.