New Beginnings Waverly LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1089815-3-SUDX Issued in MN

Legal business name

NEW BEGINNINGS WAVERLY LLC

Practice address

7300 Estes Ave SW
Waverly, MN 55390-8432

Phone

(763) 658-5800

NPI assigned

Jul 10, 2018

Organization subpart

Yes

Parent organization

MERIDIAN BEHAVIORAL HEALTHAs reported in NPPES

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

Authorized official

Name

Lisa Marie Asper

Title

Director of Contracting, Credential

Phone

(612) 454-2046

Specialties & licenses 1

Addresses

Tax ID family

New Beginnings Waverly LLC2 organizations share this tax ID, including this one

Part of

New Beginnings Waverly LLC

Other organizations with this tax ID 1

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

• New Beginnings Waverly LLC

  • Substance Abuse Rehabilitation Facility
  • Waverly, MN
  • NPI 1386155901
  NPD tax ID

Locations

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1972099240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST STE 190",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551123271",
            "telephone_number": "612-454-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 ESTES AVE SW",
            "city": "WAVERLY",
            "state": "MN",
            "postal_code": "553908432",
            "telephone_number": "763-658-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BEGINNINGS WAVERLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERIDIAN BEHAVIORAL HEALTH",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "ASPER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING, CREDENTIAL",
        "authorized_official_telephone_number": "612-454-2046"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1089815-3-SUDX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Latanya Hanson, M.A., LPCC
• Timarie Leahy, RN
• New Beginings at Waverly, LLC
• New Beginnings at Waverly, LLC
• New Beginnings Waverly LLC
• Nordell Family Services LLC
• The Elders Nest LLC
• Wendy Wagener
• April Marie Westermann, LPTA

• Substance Abuse Rehabilitation Facility in Waverly, MN
• Providers in Waverly, 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 Jul 10, 2018; 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.