NPIMap

Organization Active NPI

Northland Counseling Center, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Grand Rapids, MN
National Provider Identifier
1407045461
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
NORTHLAND COUNSELING CENTER, INC.
Practice address
1307 S Pokegama Ave
Grand Rapids, MN 55744-4210
Phone
(218) 327-1151
NPI assigned
Oct 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
K. Greg Walker
Title
Ceo
Phone
(218) 326-0099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1307 S Pokegama Ave
Grand Rapids, MN 55744-4210

Mailing address

215 SE 2ND Ave
Grand Rapids, MN 55744-3615

National Provider Directory

National Provider Directory
Tax ID family
Northland Counseling CT10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1407045461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S POKEGAMA AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444210",
            "telephone_number": "218-327-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "K.",
        "authorized_official_middle_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-326-0099"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.