MN Prevention & Recovery Alliance, LLC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

MN PREVENTION & RECOVERY ALLIANCE, LLC

Practice address

1619 Portland Ave
Minneapolis, MN 55404-1507

Phone

(612) 440-3967

NPI assigned

Jun 13, 2022

Organization subpart

No

Name

Tracee Anderson

Title

Executive Director

Phone

(612) 440-3967

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2022.

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1992435952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041507",
            "telephone_number": "612-440-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041507",
            "telephone_number": "612-440-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MN PREVENTION & RECOVERY ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TRACEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-440-3967"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Minneapolis, MN
• Peer Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.