NPIMap

Organization Active NPI

Victory Through Faith Recovery Servies

Doing business as The Micah House

  • Community/Behavioral Health Agency
  • Minneapolis, MN
National Provider Identifier
1720458300
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1069387 Issued in MN
Legal business name
VICTORY THROUGH FAITH RECOVERY SERVIES
Doing business as
The Micah House
Practice address
1523 Nicollet Ave
Minneapolis, MN 55403-2723
Phone
(612) 314-2460
Fax
(612) 871-4290
NPI assigned
Sep 25, 2015
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
VICTORY THROUGH FAITH RECOVERY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
William Lockett
Title
Ceo
Phone
(612) 314-2460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1069387 MN Primary

Addresses

Primary practice location

1523 Nicollet Ave
Minneapolis, MN 55403-2723

Mailing address

1523 Nicollet Ave
Minneapolis, MN 55403-2723
Phone (612) 314-2460

Other names 1

  • The Micah House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Victory Through Faith Recovery Services3 organizations share this tax ID, including this one
Part of
Victory Through Faith Recovery Services

Other organizations with this tax ID 2

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

Locations

1523 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 314-2460

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1720458300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032723",
            "telephone_number": "612-314-2460",
            "fax_number": "612-871-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032723",
            "telephone_number": "612-314-2460",
            "fax_number": "612-871-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY THROUGH FAITH RECOVERY SERVIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VICTORY THROUGH FAITH RECOVERY SERVICES",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "LOCKETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-314-2460"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1069387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Micah House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.