VALHALLA PLACE BRAINERD LLC NPI 1881972503

NPI Information

  • NPI: 1881972503
  • Provider Name: VALHALLA PLACE BRAINERD LLC
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • CLIA Number: 24D2149202
  • Address: 2215 S 6TH ST
    BRAINERD, MN
    ZIP 56401
  • Phone: (763) 276-4856

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NPI Details

VALHALLA PLACE BRAINERD LLC is a methadone clinic center in Brainerd, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. VALHALLA PLACE BRAINERD LLC NPI is 1881972503. The provider is registered as an organization entity type.

The provider's business location address is:

2215 S 6TH ST
BRAINERD, MN
ZIP 56401-549
Phone: (763) 276-4856

The provider's authorized official is Jay Higham .
The authorized official title is Ceo and has the following contact phone number (214) 365-6112.

The CLIA number assigned to this NPI record is 24D2149202 - other - substance abuse treatment with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm (HCPCS:G2067)
  • Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure (HCPCS:G2078)

The enumeration date for this NPI number is 7/29/2011 and was last updated on 12/27/2024.

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
1261QM2800XClinic/CenterMethadoneMINNESOTAYes

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: 3/30/2025

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