Midwest Residential Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

381821 Issued in MN

Legal business name

MIDWEST RESIDENTIAL INC

Practice address

10917 Humboldt Ave S
Bloomington, MN 55431-4221

Phone

(651) 315-2649

NPI assigned

Oct 28, 2017

Organization subpart

No

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

Authorized official

Name

Faiza HassanNPI 1841652898

Title

Ceo

Phone

(651) 315-2649

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Faiza Hassan

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bloomington, MN
  • NPI 1841652898

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1509148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1578075750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554234647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10917 HUMBOLDT AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314221",
            "telephone_number": "651-315-2649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10325 Zinran Ave S",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554381961",
            "country_code": "US",
            "telephone_number": "651-315-2649",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5620 W 99th St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554372227",
            "country_code": "US",
            "telephone_number": "651-315-2649",
            "fax_number": "612-979-2604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7800 W 101st St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554382071",
            "country_code": "US",
            "telephone_number": "651-315-2649",
            "fax_number": "612-979-2604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10449 Johnson Ave S",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554372819",
            "country_code": "US",
            "telephone_number": "651-315-2649",
            "fax_number": "612-979-2604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST RESIDENTIAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "FAIZA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-315-2649"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": "381821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Marie Mickelsen
• Brianne Mickelson
• Gracie Mae Mickschl
• Midwest Autism & Psychological Services, PLLC
• Midwest Recovery, Inc (Midwest Health)
• Midwest Resiential Achc
• Vincent Mikaye
• Rachel Miklya, RDN, LD, CPT
• Marissa J Milan
• Brett John Milbrandt, MD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.