Organization Active NPI

Alliance Wellness Clinic Inc.

  • Methadone Clinic
  • Bloomington, MN
National Provider Identifier
1780186130
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
ALLIANCE WELLNESS CLINIC INC.
Practice address
8040 Old Cedar Ave. S. Ste. 100
Bloomington, MN 55425-1211
Phone
(952) 693-0080
Fax
(952) 955-6567
NPI assigned
Mar 1, 2018
Last updated
Apr 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Ms. Patricia Joann Friedman, LADCNPI 1194230045
Title
Treatment Director
Phone
(952) 693-0080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X MN

Addresses

Primary practice location

8040 Old Cedar Ave. S. Ste. 100
Bloomington, MN 55425-1211

Mailing address

8040 Old Cedar Ave. S. Ste. 100
Bloomington, MN 55425-1211
Phone (952) 693-0080

Other identifiers 1

IdentifierTypeStateIssuer
1780186130OtherMNNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@alliancewellnessclinic.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opioid treatment program
Medicare-enrolled since Jun 30, 2026

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2216296Alliance Wellness Clinic, Inc8040 Old Cedar Ave S Ste 100, Bloomington, MN 55425Certificate of waiverMar 10, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1519862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1780186130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 OLD CEDAR AVE. S. STE. 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251211",
            "telephone_number": "952-693-0080",
            "fax_number": "952-955-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 OLD CEDAR AVE. S. STE. 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251211",
            "telephone_number": "952-693-0080",
            "fax_number": "952-955-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE WELLNESS CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-01",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JOANN",
        "authorized_official_title_or_position": "TREATMENT DIRECTOR",
        "authorized_official_telephone_number": "952-693-0080",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780186130",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@alliancewellnessclinic.com",
            "affiliation": "N",
            "endpointDescription": "direct email to clinic staff",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8040 Old Cedar Ave. S. Ste. 100",
            "city": "Bloomington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554251211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.