Minnesota Recovery Connection

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

MINNESOTA RECOVERY CONNECTION

Doing business as

Minnesota Recovery Connection

Practice address

2446 University Ave W Ste 112
Saint Paul, MN 55114-1740

Phone

(612) 584-4158

Fax

(612) 886-3940

NPI assigned

Mar 11, 2019

Last updated

Mar 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tiffany Da'Shay Irvin, CPRS

Title

Manager of Peer Services

Phone

(651) 321-1100

Specialties & licenses 1

Addresses

Other names 1

• Minnesota Recovery Connection Doing business as

Locations

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1821556614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 UNIVERSITY AVE W STE 112",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141740",
            "telephone_number": "612-584-4158",
            "fax_number": "612-886-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 UNIVERSITY AVE W STE 112",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141740",
            "telephone_number": "612-584-4158",
            "fax_number": "612-886-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA RECOVERY CONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "IRVIN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "DA'SHAY",
        "authorized_official_title_or_position": "MANAGER OF PEER SERVICES",
        "authorized_official_telephone_number": "651-321-1100",
        "authorized_official_credential": "CPRS"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnesota Recovery Connection",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Peer Specialist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Peer Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.