Axis Behavioral Health, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

AXIS BEHAVIORAL HEALTH, INC

Practice address

740 12TH Ave S
Saint Cloud, MN 56301-4219

Phone

(612) 644-3912

NPI assigned

Apr 5, 2019

Organization subpart

No

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

Authorized official

Name

Bosteya Abdulahi Farah

Title

President

Phone

(612) 644-3912

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1497217699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 12TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014219",
            "telephone_number": "612-644-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 12TH AVE S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014219",
            "telephone_number": "612-644-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "BOSTEYA",
        "authorized_official_middle_name": "ABDULAHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-644-3912"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "s.abdi@axisbehavioralhealth.com",
            "affiliation": "N",
            "endpointDescription": "Secure Encrypted Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "740 12th Ave S",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563014219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Authentic Self Therapy PLLC
• Autism Partners Inc
• Sarah Avery, RBT
• Kelly Awes, CNP
• Awesome Behavioral Health LLC
• Alaine Aysta, LMFT
• Azsentia Health
• Paitynn Baade
• Stephanie Lea Baas, PSYD LP
• Alexander Babcock, DC

• Substance Abuse Rehabilitation Facility in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.