NPIMap

Organization Active NPI

Community Addiction Recovery Enterprises

Doing business as Community Addiction Recovery Enterprises Valley Lake Boys Home

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Breckenridge, MN
National Provider Identifier
1912220229
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1046305 Issued in MN
Legal business name
COMMUNITY ADDICTION RECOVERY ENTERPRISES
Doing business as
Community Addiction Recovery Enterprises Valley Lake Boys Home
Practice address
3850 200TH Ave
Breckenridge, MN 56520
Phone
(651) 431-3676
Fax
(651) 431-7505
NPI assigned
Mar 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Doug Seiler
Title
Regional Administrator
Phone
(218) 739-7224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1046305 MN Primary

Addresses

Primary practice location

3850 200TH Ave
Breckenridge, MN 56520

Mailing address

444 Lafayette Rd N
Saint Paul, MN 55155-3802
Phone (651) 431-3676

Other names 1

  • Community Addiction Recovery Enterprises Valley Lake Boys Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Care-Brainerd10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1912220229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 LAFAYETTE RD N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551553802",
            "telephone_number": "651-431-3676",
            "fax_number": "651-431-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 200TH AVE",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "56520",
            "telephone_number": "651-431-3676",
            "fax_number": "651-431-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ADDICTION RECOVERY ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "SEILER",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "218-739-7224"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "1046305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Addiction Recovery Enterprises Valley Lake Boys Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Breckenridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.