Valhalla Place, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1048780-1-CDT Issued in MN

Legal business name

VALHALLA PLACE, LLC

Practice address

6043 Hudson Rd Ste 220
Woodbury, MN 55125-1033

Phone

(651) 925-8200

NPI assigned

Jul 2, 2008

Last updated

Dec 23, 2024By 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

Jay Higham

Title

Ceo

Phone

(214) 365-6112

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Valhalla Place, LLC

  • Methadone Clinic
  • Brooklyn Park, MN
  • NPI 1801149505

  O20200210000064

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Valhalla Place LLC2 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.

• Valhalla Place, LLC

  • Methadone Clinic
  • Brooklyn Park, MN
  • NPI 1801149505
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• B Tek, LLC

  • Clinical Medical Laboratory
  • Woodbury, MN
  • NPI 1609256122

  Member Of

  NPD member

Practitioners 1

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.

• Lilian Kigonya, M.D., M.P.H.

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1932375110
  NPD

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1881856664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251033",
            "telephone_number": "208-283-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251033",
            "telephone_number": "651-925-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALHALLA PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MN",
            "license": "1048780-1-CDT",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1048780-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Valhalla Place Clinic, P.a.
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• Valley Creek Family Dentistry
• Valley Crossing Community School
• Maggie Rose Valois, MPS, LPCC, LADC
• Jacob Fredrick Van Allen, LADC

• Community/Behavioral Health Agency in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.