Axis Residential Treatment Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AXIS RESIDENTIAL TREATMENT INC

Practice address

219 5TH St SE
Minneapolis, MN 55414-1108

Phone

(602) 903-8781

NPI assigned

Dec 1, 2021

Organization subpart

No

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

Authorized official

Name

Samira Nur

Title

Owner

Phone

(602) 903-8781

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1497413033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 5TH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554141108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 5TH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554141108",
            "telephone_number": "602-903-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS RESIDENTIAL TREATMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "NUR",
        "authorized_official_first_name": "SAMIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-903-8781"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.