Amazing Grace Recovery Services, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1093306 Issued in MN

Legal business name

AMAZING GRACE RECOVERY SERVICES, LLC

Practice address

23671 Saint Francis Blvd NW
Saint Francis, MN 55070-9802

Phone

(651) 343-3670

NPI assigned

Jul 4, 2018

Last updated

Jul 4, 2018By 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

Michael Leadens, MA, LADC

Title

President/Ceo

Phone

(651) 343-3670

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530662400000",
    "number": "1821584657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35619 HELIUM ST NW",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714791",
            "telephone_number": "651-343-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23671 SAINT FRANCIS BLVD NW",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550709802",
            "telephone_number": "651-343-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-04",
        "last_updated": "2018-07-04",
        "status": "A",
        "authorized_official_last_name": "LEADENS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "651-343-3670",
        "authorized_official_credential": "MA, LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1093306",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1093306",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Aufderheide, PT, DPT
• Thomas Battaglia, PT, DPT
• Gregory J Behl
• Erica Lynne Burman, PHARM.D., RPH.
• Micah Byers

• Addiction (Substance Use Disorder) Counselor in Saint Francis, MN
• Providers in Saint Francis, 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 Jul 4, 2018; 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.