Minnesota Ya Services LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

MINNESOTA YA SERVICES LLC

Doing business as

Newport Institute-Buffalo

Practice address

2642 56TH St NE
Buffalo, MN 55313-5626

Phone

(714) 202-5166

Fax

(844) 721-8190

NPI assigned

May 19, 2021

Last updated

Oct 2, 2025By 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

Keith Thompson

Title

Chief Legal & Development Officer

Phone

(949) 432-4622

Specialties & licenses 1

Addresses

Other names 1

• Newport Institute-Buffalo Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Minnesota Ya Services LLC2 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.

• Minnesota Ya Services LLC

  dba Newport Institute-Monticello

  • Psychiatric Residential Treatment Facility
  • Monticello, MN
  • NPI 1104490481
  NPD tax ID

Locations

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1487228763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-4180",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432604180",
            "telephone_number": "714-202-5166",
            "fax_number": "844-721-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 56TH ST NE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553135626",
            "telephone_number": "714-202-5166",
            "fax_number": "844-721-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA YA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CHIEF LEGAL & DEVELOPMENT OFFICER",
        "authorized_official_telephone_number": "949-432-4622"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Institute-Buffalo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newport Institute-Buffalo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebekka Aili Miller
• Robert Milligan, MD
• Tara Rose Minerich, RN
• Minnesota Teen Challenge, Inc (Rockbridge Treatment and Recovery)
• Minnesota Teen Challenge, Inc. (MN Adult & Teen Challenge, Inc.)
• Marisa D Moline, APRN, CNP, CBIS
• Jonathan David Morris
• Brian Moselle
• Robert Thomas Mullaney, M.D.
• Michelle Ann Mulligan

• Psychiatric Residential Treatment Facility in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Psychiatric Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.