SE Homes Recovery Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

1074798-2-CDT Issued in MN

Legal business name

SE HOMES RECOVERY INC

Practice address

4020 Minnehaha Ave Ste 2070
Minneapolis, MN 55406-4529

Phone

(612) 702-7231

NPI assigned

Aug 21, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Abah Abdul Mohamed

Title

Program Director

Phone

(612) 702-7231

Specialties & licenses 1

Addresses

Other names 1

• South East Homes Inc. Doing business as

Tax ID family

SE Homes Recovery 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.

• South East Homes Inc

  • Substance Abuse Rehabilitation Facility
  • Minneapolis, MN
  • NPI 1336432087
  NPD tax ID

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1437526720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 17TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044001",
            "telephone_number": "612-702-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 MINNEHAHA AVE STE 2070",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554064529",
            "telephone_number": "612-702-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE HOMES RECOVERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ABAH",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "612-702-7231",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1074798-2-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South East Homes Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Erin Scott, P.T.
• Walter K Scott, CRNA
• Kirk Scudder
• Jane Frances Scullin, OTR
• Diane Marie Scuto
• David J Seabolt, NP
• Jon Konrad Seaburg, LADC , LPCC
• Mark D Seaburg
• Emma L Seamans
• Matthew A Seamon, MA LAT ATC

• Substance Use Disorder Rehabilitation Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.