MEDICARE: MIDWEST RECOVERY, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	343900000X	Non-emergency Medical Transport (VAN)
4	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1801268354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST RECOVERY, INC

Provider Business Mailing Address
First Line	:	2626 E 82ND ST STE 335
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-1682
Country	:	US
Telephone Number	:	612-584-4858
Fax Number	:	612-444-3292

Provider Business Practice Location Address
First Line	:	2626 E 82ND ST STE 335
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55425-1682
Country	:	US
Telephone Number	:	612-584-4860
Fax Number	:	612-444-3292

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL J MCHUGH
Credential	:
Telephone Number	:	612-584-4858

Provider Enumeration Date	:	10/23/2015
Last Update Date	:	01/24/2025

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