Pine Manors Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

8019182CDT Issued in MN

Legal business name

PINE MANORS INC

Practice address

22195 State 34
Nevis, MN 56467

Phone

(218) 732-4337

Fax

(218) 732-0399

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By 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

Mrs. Rachel Jean Mueller, LADC

Title

Director Chief Operating Officer

Phone

(218) 732-4337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568560902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22195 STATE 34",
            "city": "NEVIS",
            "state": "MN",
            "postal_code": "56467",
            "telephone_number": "218-732-4337",
            "fax_number": "218-732-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22195 STATE 34",
            "city": "NEVIS",
            "state": "MN",
            "postal_code": "56467",
            "telephone_number": "218-732-4337",
            "fax_number": "218-732-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE MANORS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "218-732-4337",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "8019182CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• County of Hubbard-Ind School Dist. 308
• Beverlee Ann Hallaway
• Julie Ann Nicklason, RN
• David Alan Robinson, R.PH.
• Stellher Human Services
• Cassandra Swenson, MSW, LGSW

• Substance Abuse Rehabilitation Facility in Nevis, MN
• Providers in Nevis, 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 Aug 22, 2020; 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.