NPIMap

Organization Active NPI

Rewind, Inc

  • Substance Abuse Rehabilitation Facility
  • Perham, MN
National Provider Identifier
1801209697
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
10348381CDT Issued in MN
Legal business name
REWIND, INC
Practice address
840 E Main St
Perham, MN 56573-1934
Phone
(218) 346-6100
Fax
(218) 346-6112
NPI assigned
Jun 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Authorized official

Name
Kurt David Holm, LADCNPI 1396158358
Title
Counselor
Phone
(218) 346-6100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 10348381CDT MN Primary

Addresses

Primary practice location

840 E Main St
Perham, MN 56573-1934

Mailing address

840 E Main St
Perham, MN 56573-1934
Phone (218) 346-6100

Other identifiers 1

IdentifierTypeStateIssuer
302032OtherMNLADC LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Rewind Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1801209697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E MAIN ST",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731934",
            "telephone_number": "218-346-6100",
            "fax_number": "218-346-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E MAIN ST",
            "city": "PERHAM",
            "state": "MN",
            "postal_code": "565731934",
            "telephone_number": "218-346-6100",
            "fax_number": "218-346-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REWIND, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "218-346-6100",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "10348381CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC LICENSE",
            "identifier": "302032",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perham, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.