Rem Woodvale, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

830935-4-WS Issued in MN

Legal business name

REM WOODVALE, INC.

Practice address

1836 S Cedar Ave
Owatonna, MN 55060-4204

Phone

(507) 451-1296

NPI assigned

Dec 19, 2006

Last updated

Mar 5, 2023By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

Tax ID family

Rem Woodvale Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rem Woodvale, Inc.

  • Community/Behavioral Health Agency
  • Owatonna, MN
  • NPI 1386768703
  NPD tax ID

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677974400000",
    "number": "1417011263",
    "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": "952-925-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 S CEDAR AVE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604204",
            "telephone_number": "507-451-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM WOODVALE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "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": "830935-4-WS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295718300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie G Randall
• Redeeming Mind
• Nicholas Scott Reich
• Anthony D Reigel
• Rem Woodvale, Inc.
• Gia Rendon, PA-C
• Renewal Oasis Wellness Center P.C.
• London Ray Repke, CMT
• Rachel Suzanne Repke, CMT
• Dennis J Rinehart, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.