Northwest Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NORTHWEST RECOVERY CENTER

Practice address

115 6TH St W
Thief River Falls, MN 56701-1511

Phone

(218) 681-6561

Fax

(218) 681-0477

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Paul Dennis Olson, M.A., LADC

Title

Administrator

Phone

(218) 681-6561

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609947985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 6TH ST W",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567011511",
            "telephone_number": "218-681-6561",
            "fax_number": "218-681-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 6TH ST W",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567011511",
            "telephone_number": "218-681-6561",
            "fax_number": "218-681-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-681-6561",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1030141",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "167478",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5087964",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE CROSS",
            "identifier": "4271NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BLUE PLUS",
            "identifier": "4271NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Justin Alan Olson
• Kathryn Victoria Olson, PHARMD
• Daniel L Paeth, MD

• Substance Abuse Rehabilitation Facility in Thief River Falls, MN
• Providers in Thief River Falls, 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.