Healthcare Provider Details

I. General information

NPI: 1649610841
Provider Name (Legal Business Name): NEXUS FAMILY HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HEMLOCK
MANTENO IL
60950
US

IV. Provider business mailing address

505 HIGHWAY 169 N STE 500
PLYMOUTH MN
55441-6447
US

V. Phone/Fax

Practice location:
  • Phone: 815-802-3700
  • Fax: 815-468-2320
Mailing address:
  • Phone: 763-551-8640
  • Fax: 763-553-1637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number223668-06
License Number StateIL

VIII. Authorized Official

Name: CHRISTOPHER HARTKEMEYER
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 763-551-8640