ST. JUDE RETREAT HOUSE LLC NPI 1184943797

NPI Information

NPI: 1184943797
Provider Name: ST. JUDE RETREAT HOUSE, LLC

Other Name: ALPP INSTITUTE

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
5875 FLEUR DR
DES MOINES, IA
ZIP 50321
Phone: (800) 990-0340
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ST. JUDE RETREAT HOUSE, LLC is a substance abuse rehabilitation facility in Des Moines, IA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. ST. JUDE RETREAT HOUSE, LLC NPI is 1184943797. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Alpp Institute.

The provider's business location address is:

5875 FLEUR DR
DES MOINES, IA
ZIP 50321-883
Phone: (800) 990-0340
Fax: (954) 208-5770

The provider's authorized official is Mike Vasquez .
The authorized official title is Ceo and has the following contact phone number (800) 990-0340.

The enumeration date for this NPI number is 5/21/2010 and was last updated on 12/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	01930	IOWA	No
2	324500000X	Substance Abuse Rehabilitation Facility		1340	IOWA	Yes
3	363L00000X	Nurse Practitioner		A054289	IOWA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0112726	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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