NPIMap

Organization Active NPI

Cochran Recovery Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hastings, MN
National Provider Identifier
1629471099
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
80061110CDT Issued in MN
Legal business name
COCHRAN RECOVERY SERVICES, INC.
Practice address
310 Vermillion St
Hastings, MN 55033-1237
Phone
(651) 438-2639
Fax
(651) 438-2752
NPI assigned
Sep 30, 2014
Last updated
Oct 1, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
COCHRAN RECOVERY SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Mr. Richard A Terzick, MA
Title
Executive Director
Phone
(651) 437-4209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 80061110CDT MN Primary

Addresses

Primary practice location

310 Vermillion St
Hastings, MN 55033-1237

Mailing address

1294 18TH St E
Hastings, MN 55033-3680
Phone (651) 437-4209

Other identifiers 3

IdentifierTypeStateIssuer
1134394828MedicaidMN
1629471099MedicaidMN
1821491465MedicaidMN

Other names 1

  • Cochran Out Patient Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Dakota County Receiving Center4 organizations share this tax ID, including this one
Part of
Dakota County Receiving Center

Other organizations with this tax ID 3

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

Locations

310 Vermillion St
Hastings, MN 55033
Phone (651) 438-2639

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1629471099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 18TH ST E",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550333680",
            "telephone_number": "651-437-4209",
            "fax_number": "651-438-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 VERMILLION ST",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331237",
            "telephone_number": "651-438-2639",
            "fax_number": "651-438-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCHRAN RECOVERY SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COCHRAN RECOVERY SERVICES, INC.",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "TERZICK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "651-437-4209",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "80061110CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134394828",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629471099",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821491465",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cochran Out Patient Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hastings, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.