Juel Fairbanks Chemical Dependency Services

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

License

803854-3-CDT Issued in MN

Legal business name

JUEL FAIRBANKS CHEMICAL DEPENDENCY SERVICES

Practice address

804 Albert St N
Saint Paul, MN 55104

Phone

(651) 282-0460

Fax

(651) 644-1126

NPI assigned

May 10, 2010

Organization subpart

No

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

Authorized official

Name

Janice Lindstrom

Title

Executive Director

Phone

(651) 282-0460

Specialties & licenses 1

Addresses

Tax ID family

Juel Fairbanks Chemical Dependency Services2 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.

• Juel Fairbanks Chemical Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Saint Paul, MN
  • NPI 1649440355
  NPD tax ID

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1982922324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 ALBERT ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041303",
            "telephone_number": "651-282-0460",
            "fax_number": "651-644-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ALBERT ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-282-0460",
            "fax_number": "651-644-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUEL FAIRBANKS CHEMICAL DEPENDENCY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "LINDSTROM",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "651-282-0460"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "MN",
            "license": "803854-3-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JT Hoeschen Inc
• JTP Professional Service Corporation
• Brianna Marie Judd, M.D.
• Ernest Juean, DDS
• Juel Fairbanks Chemical Dependency Services
• Patrick Juenemann, M.D.
• Hannah E Juettner
• Julia Moen, LLC
• Julian C. Ernst, Licsw
• Roxanne L Julius, DPT

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.