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NPI Code Detail

MEDICARE: COCHRAN RECOVERY SERVICES

MEDICARE: COCHRAN RECOVERY SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility1004916-3-DSMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11004916-3-DSOTHERMNSTATE OF MN

General Provider Information

NPI Number : 1134394828
Entity Type Code : Organization
Provider Name (Legal Business Name) : COCHRAN RECOVERY SERVICES
Provider Business Mailing Address
First Line : 2000 WHITE BEAR AVE N
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-3713
Country : US
Telephone Number : 651-437-4209
Fax Number :
Provider Business Practice Location Address
First Line : 2000 WHITE BEAR AVE N
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-3713
Country : US
Telephone Number : 651-437-4209
Fax Number :
Authorized Official
Title or Position : COO
Name : TOM MEIER
Credential :
Telephone Number : 612-767-0313
Provider Enumeration Date : 04/24/2008
Last Update Date : 02/07/2025

Similar Medicare Providers

1134061096 — MR. ANDREW JOHN LARSON MS, LPCC, LADC
Practice Location Address:
2000 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-3713
Practice Phone: 651-216-9361
Practice Fax:
1184018053 — JACQUELYN HANSON PTA
Practice Location Address:
2000 WHITE BEAR AVE N
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Practice Fax:
1053873406 — STEPHEN BRENNAN
Practice Location Address:
2000 WHITE BEAR AVE N
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55109-3713
Practice Phone: 612-235-4620
Practice Fax:
1720685019 — MADELINE SCHUETTE MSW, LICSW, LADC
Practice Location Address:
2000 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-3713
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Practice Fax:
1629798897 — BINOD PRASAD BASAULA MS, LADC, LPCC
Practice Location Address:
2000 WHITE BEAR AVE N
MAPLEWOOD, MN
55109-3713
Practice Phone: 651-437-4209
Practice Fax:
1699760785 — RAMSEY COUNTY MENTAL HEALTH CENTER
Practice Location Address:
2000 WHITE BEAR AVE N
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Practice Phone: 651-777-7486
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Directions to “COCHRAN RECOVERY SERVICES ” Practice Location

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