NPIMap

Organization Active NPI

Range Mental Health Center Inc

Doing business as Detox

  • Substance Abuse Rehabilitation Facility
  • Virginia, MN
National Provider Identifier
1851419345
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RANGE MENTAL HEALTH CENTER INC
Doing business as
Detox
Practice address
626 S 13TH St
Virginia, MN 55792
Phone
(218) 741-9120
Fax
(218) 741-3170
NPI assigned
Mar 26, 2007
Last updated
Apr 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Mary J Carpenter, MSED, LPNPI 1265533640
Title
Chief Executive Officer
Phone
(218) 749-2881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

626 S 13TH St
Virginia, MN 55792

Mailing address

624 S 13TH St
Virginia, MN 55792
Phone (218) 749-2881

Other identifiers 2

IdentifierTypeStateIssuer
5042378OtherMNMEDICA
3L52RAOtherMNBLUE CROSS BLUE SHIELD

Other names 1

  • Detox Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ranger Mental Health CT5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

626 13th St S
Virginia, MN 55792
Phone (218) 741-9120

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1851419345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S 13TH ST",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-749-2881",
            "fax_number": "218-749-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 S 13TH ST",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "55792",
            "telephone_number": "218-741-9120",
            "fax_number": "218-741-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANGE MENTAL HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "218-749-2881",
        "authorized_official_credential": "MSED, LP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "5042378",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3L52RA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.