Organization Active NPI

Elite Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1679949044
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ELITE RECOVERY LLC
Practice address
1137 Grand Ave
Saint Paul, MN 55105-2629
Phone
(651) 698-7358
NPI assigned
Aug 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Andrew Ryan Horowitz
Title
Owner
Phone
(612) 500-1269

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MN
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

1137 Grand Ave
Saint Paul, MN 55105-2629

Mailing address

1137 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 698-7358

Other practice location 1

840 Grand Ave
Saint Paul, MN 55105-3330
Phone (612) 719-4137

Other practice location 2

937 Grand Ave
Saint Paul, MN 55105-3015
Phone (612) 719-4137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251002004812 MN Part B Supplier - Clinic/Group Practice 5496251985 Receives reassigned benefits from 9 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

937 Grand Ave
Saint Paul, MN 55105
Phone (612) 719-4137

1145 Grand Ave
Ste 101
Saint Paul, MN 55105
Phone (612) 719-4137

840 Grand Ave
Saint Paul, MN 55105
Phone (612) 719-4137

758 Grand Ave
Saint Paul, MN 55105
Phone (612) 719-4137

1137 Grand Ave
Saint Paul, MN 55105
Phone (612) 500-0161

1145 Grand Ave
#101
Saint Paul, MN 55105
Phone (612) 424-0051

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1679949044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-698-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 GRAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052629",
            "telephone_number": "651-698-7358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "840 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551053330",
            "country_code": "US",
            "telephone_number": "612-719-4137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "937 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551053015",
            "country_code": "US",
            "telephone_number": "612-719-4137",
            "fax_number": "651-846-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "HOROWITZ",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-500-1269"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "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 Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.