Active NPI
Tbi Residential and Community Services, Inc.
- Assisted Living Facility
- Duluth, MN
National Provider Identifier
1669075719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- TBI RESIDENTIAL AND COMMUNITY SERVICES, INC.
- Practice address
- 2016 W Superior St
Duluth, MN 55806-3524 - Phone
- (218) 733-1331
- NPI assigned
- Nov 20, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brett Ian Cohen
- Title
- Coo
- Phone
- (800) 388-5150
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
2016 W Superior St
Duluth, MN 55806-3524
Mailing address
6600 France Ave S
Edina, MN 55435-1805
Phone (952) 922-6776
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 394034 | Medicaid | MN |
National Provider Directory
National Provider Directory- Tax ID family
- Tbi Residential and Community Services Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Duluth, MN
- NPI 1407516321
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Duluth, MN
- NPI 1518560580
-
- Adult Day Care Clinic/Center
- Duluth, MN
- NPI 1639772684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1677888000000",
"number": "1669075719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 FRANCE AVE S",
"city": "EDINA",
"state": "MN",
"postal_code": "554351805",
"telephone_number": "952-922-6776",
"fax_number": "952-922-6885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 W SUPERIOR ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558063524",
"telephone_number": "218-733-1331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TBI RESIDENTIAL AND COMMUNITY SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2020-11-20",
"last_updated": "2023-03-04",
"certification_date": "2023-03-04",
"status": "A",
"authorized_official_last_name": "COHEN",
"authorized_official_first_name": "BRETT",
"authorized_official_middle_name": "IAN",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "800-388-5150"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "394034",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
- Mya Camryn Taylor
- Quinton Allan Taylor, MD
- Tbi Residential & Community Services
- Tbi Residential and Community Services, Inc.
- Tbi Residential and Community Services, Inc.
- Robin Leslie Tedlund
- Angela Kay Teigland, MEDICAL ASSISTANT
- Laszlo Steven Tekler, DO
- Jared Temple, PHARMD
- Tender Loving Care of Duluth, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.