Pioneer Recovery Center LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PIONEER RECOVERY CENTER LLC

Practice address

5388 Road 37
Aurora, MN 55705-8338

Phone

(218) 393-1421

NPI assigned

Oct 29, 2008

Last updated

Oct 29, 2008By 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

Jennifer Dawn Nyakundi, LADC, CADC III

Title

Co-Owner/Co-Director

Phone

(218) 393-1421

Specialties & licenses 1

Addresses

Tax ID family

Pioneer Recovery Center 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.

• Pioneer Recovery Center LLC

  • Substance Abuse Rehabilitation Facility
  • Aurora, MN
  • NPI 1376737064
  NPD tax ID

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1891948238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5388 ROAD 37",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "557058338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5388 ROAD 37",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "557058338",
            "telephone_number": "218-393-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "NYAKUNDI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CO-OWNER/CO-DIRECTOR",
        "authorized_official_telephone_number": "218-393-1421",
        "authorized_official_credential": "LADC, CADC III"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Pines Medical Center (Essentia Health Northern Pines)
• Northern Pines Medical Center (Essentia Health Northern Pines)
• Ol-US Aurora, LLC
• Justin Peyla, DPT
• Pioneer Recovery Center LLC
• Ashley E Pionk, SLP
• Tracy Powell
• River Iron Therapy, LLC
• David Michael Rokser, APRN, CNP
• John Wayne Samuelson, DC

• Substance Abuse Rehabilitation Facility in Aurora, MN
• Providers in Aurora, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.