NPIMap

Organization Active NPI

Rem Hennepin Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Edina, MN
National Provider Identifier
1386729978
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
10120432RS Issued in MN
Legal business name
REM HENNEPIN INC
Practice address
5100 William Avenue
Edina, MN 55436
Phone
(952) 922-6776
Fax
(952) 922-6885
NPI assigned
Oct 25, 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 Disabilities Intermediate Care Facility 315P00000X 10120432RS MN Primary

Addresses

Primary practice location

5100 William Avenue
Edina, MN 55436

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
610063500MedicaidMN

Other names 1

  • REM Hennepin Inc William Other name

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1386729978",
    "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": "5100 WILLIAM AVENUE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55436",
            "telephone_number": "952-922-6776",
            "fax_number": "952-922-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM HENNEPIN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "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": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "10120432RS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610063500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REM Hennepin Inc William",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "REM Hennepin Inc William",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edina, 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.