NPIMap

Organization Active NPI

Jacy 1

Doing business as Anchorage

  • Substance Abuse Rehabilitation Facility
  • Saint Cloud, MN
National Provider Identifier
1982879912
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
10447991CDT Issued in MN
Legal business name
JACY 1
Doing business as
Anchorage
Practice address
600 25TH Ave S Ste 105
Saint Cloud, MN 56301-4820
Phone
(320) 255-9530
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Laura Lee Litke
Title
Executive Assistant
Phone
(320) 255-9530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 10447991CDT MN Primary

Addresses

Primary practice location

600 25TH Ave S Ste 105
Saint Cloud, MN 56301-4820

Mailing address

600 25TH Ave S Ste 105
Saint Cloud, MN 56301-4820
Phone (320) 255-9530

Other names 1

  • Anchorage Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anchorage2 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.

Locations

600 25th Ave S
Ste 105
Saint Cloud, MN 56301
Phone (320) 255-9530

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1982879912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014820",
            "telephone_number": "320-255-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S STE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014820",
            "telephone_number": "320-255-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACY 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "LITKE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "320-255-9530"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "10447991CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchorage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.