NPIMap

Organization Active NPI

River Ridge, LLC

  • Substance Abuse Rehabilitation Facility
  • Burnsville, MN
National Provider Identifier
1669842373
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RIVER RIDGE, LLC
Practice address
151 W Burnsville Pkwy
Suite 100
Burnsville, MN 55337-2524
Phone
(952) 564-3000
NPI assigned
Oct 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Brian P Sammon, MA, LMFT, LADC
Title
President
Phone
(952) 564-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

151 W Burnsville Pkwy
Suite 100
Burnsville, MN 55337-2524

Mailing address

5708 Glen Ave
Minnetonka, MN 55345-6611
Phone (952) 345-2390

Other names 1

  • Glen Creek Lodge Other name

National Provider Directory

National Provider Directory
Tax ID family
River Ridge LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1669842373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 GLEN AVE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553456611",
            "telephone_number": "952-345-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W BURNSVILLE PKWY",
            "address_2": "SUITE 100",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372524",
            "telephone_number": "952-564-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "SAMMON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-564-3000",
        "authorized_official_credential": "MA, LMFT, LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Creek Lodge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.