NPIMap

Organization Active NPI

Juel Fairbanks Chemical Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Saint Paul, MN
National Provider Identifier
1649440355
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
803854-3-CDT Issued in MN
Legal business name
JUEL FAIRBANKS CHEMICAL DEPENDENCY SERVICES
Practice address
806 Albert St N
Saint Paul, MN 55104-1303
Phone
(651) 644-6204
Fax
(651) 644-1126
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
Mrs. Janice Lindstrom
Title
Executive Direcotr
Phone
(651) 644-6204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 803854-3-CDT MN Primary

Addresses

Primary practice location

806 Albert St N
Saint Paul, MN 55104-1303

Mailing address

806 Albert St N
Saint Paul, MN 55104-1303
Phone (651) 644-6204

National Provider Directory

National Provider Directory
Tax ID family
Juel Fairbanks Chemical Dependency Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

806 Albert St N
Saint Paul, MN 55104
Phone (651) 644-6204

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1649440355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 ALBERT ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041303",
            "telephone_number": "651-644-6204",
            "fax_number": "651-644-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 ALBERT ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041303",
            "telephone_number": "651-644-6204",
            "fax_number": "651-644-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUEL FAIRBANKS CHEMICAL DEPENDENCY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "LINDSTROM",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECOTR",
        "authorized_official_telephone_number": "651-644-6204",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "803854-3-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.