My Home Inc

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1015883-1-CDT Issued in MN

Legal business name

MY HOME INC

Practice address

420 N 5TH St
Suite 949
Minneapolis, MN 55401-1348

Phone

(612) 343-0661

Fax

(612) 341-8353

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Farris L. Glover, LADC

Title

Executive Director

Phone

(651) 659-0359

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730286758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 UNIVERSITY AVE W",
            "address_2": "SUITE 1",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044746",
            "telephone_number": "651-659-0359",
            "fax_number": "651-645-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N 5TH ST",
            "address_2": "SUITE 949",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011348",
            "telephone_number": "612-343-0661",
            "fax_number": "612-341-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "FARRIS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "651-659-0359",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1015883-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Minneapolis, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.