NPIMap

Organization Active NPI

Avivo

  • Case Management Agency
  • Minneapolis, MN
National Provider Identifier
1629122924
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
AVIVO
Doing business as
Recovery Resource Center
Practice address
1900 Chicago Ave
Minneapolis, MN 55404-1903
Phone
(612) 752-8000
Fax
(612) 752-8001
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Kelly Matter
Title
Ceo
Phone
(612) 752-8052

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Community/Behavioral Health Agency 251S00000X 801609-2-CDT MN

Addresses

Primary practice location

1900 Chicago Ave
Minneapolis, MN 55404-1903

Mailing address

1900 Chicago Ave
Minneapolis, MN 55404-1903
Phone (612) 752-8000

Other identifiers 1

IdentifierTypeStateIssuer
859255100MedicaidMN

Other names 1

  • Recovery Resource Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avivo9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1629122924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041903",
            "telephone_number": "612-752-8000",
            "fax_number": "612-752-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041903",
            "telephone_number": "612-752-8000",
            "fax_number": "612-752-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "MATTER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-752-8052"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "801609-2-CDT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "859255100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery Resource Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.