NPIMap

Organization Active NPI

St. Cloud Hospital

Doing business as Journey Home

  • Substance Abuse Rehabilitation Facility
  • Sauk Rapids, MN
National Provider Identifier
1427218957
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
331506 Issued in MN
Legal business name
ST. CLOUD HOSPITAL
Doing business as
Journey Home
Practice address
1485 10TH Ave NE
Sauk Rapids, MN 56379-9838
Phone
(320) 259-9149
Fax
(320) 259-4565
NPI assigned
Jun 9, 2008
Last updated
Oct 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Mr. Michael A. Blair
Title
Sr. Vice President & Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 331506 MN Primary

Addresses

Primary practice location

1485 10TH Ave NE
Sauk Rapids, MN 56379-9838

Mailing address

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Other identifiers 1

IdentifierTypeStateIssuer
178755100MedicaidMN

Other names 1

  • Journey Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110221000134 MN Part B Supplier - Clinic/Group Practice 4880594779 Receives reassigned benefits from 440 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Cloud, MN; Waite Park, MN; Sauk Rapids, MN; Sartell, MN; Saint Cloud, MN; Melrose, MN; Albany, MN

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1427218957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031900",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 10TH AVE NE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563799838",
            "telephone_number": "320-259-9149",
            "fax_number": "320-259-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SR. VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "320-255-5665",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "331506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178755100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Journey Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Journey Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sauk Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.