Homeward Bound, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

802812 Issued in MN

Legal business name

HOMEWARD BOUND, INC.

Practice address

7839 Brooklyn Blvd
Brooklyn Park, MN 55445-2716

Phone

(763) 566-7860

Fax

(763) 566-1819

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Donald R Priebe

Title

Ceo

Phone

(763) 525-3186

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1962589705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13895 INDUSTRIAL PARK BLVD",
            "address_2": "#100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413700",
            "telephone_number": "763-525-3186",
            "fax_number": "763-525-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7839 BROOKLYN BLVD",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452716",
            "telephone_number": "763-566-7860",
            "fax_number": "763-566-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEWARD BOUND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "PRIEBE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-525-3186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": "802812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.