NPIMap

Organization Active NPI

Red Lake Helix Sud Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1487387155
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
RED LAKE HELIX SUD SERVICES
Practice address
4309 Queen Ave N
Minneapolis, MN 55412-1105
Phone
(515) 326-2569
NPI assigned
Jul 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Charlene Andersen
Title
Revenue Generating Manager
Phone
(218) 679-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

4309 Queen Ave N
Minneapolis, MN 55412-1105

Mailing address

PO Box 566
Redlake, MN 56671-0566
Phone (218) 679-1320

Other practice location 1

813 N 5th St
Minneapolis, MN 55401-1135
Phone (515) 326-2569

Other names 1

  • Red Lake Helix Outpatient SUD Other name

National Provider Directory

National Provider Directory
Tax ID family
Red Lake Chemical Health Programs Outpatient28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1487387155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566",
            "city": "REDLAKE",
            "state": "MN",
            "postal_code": "566710566",
            "telephone_number": "218-679-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 QUEEN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121105",
            "telephone_number": "515-326-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 N 5th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554011135",
            "country_code": "US",
            "telephone_number": "515-326-2569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RED LAKE HELIX SUD SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "REVENUE GENERATING MANAGER",
        "authorized_official_telephone_number": "218-679-1320"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Lake Helix Outpatient SUD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.