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CEDAR RIDGE, INC
NPI 1043424047
Substance Abuse Rehabilitation Facility in Stillwater, MN

Active since May 09, 2007CLIA 24D2052656 · Waiver
11400 JULIANNE AVE N, STILLWATER, MN 55082(612) 326-7555 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cedar Ridge, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CEDAR RIDGE, INC (NPI 1043424047) is a healthcare organization registered as a substance abuse rehabilitation facility in Stillwater, Minnesota and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through January 14, 2027 and lists Valerie Bundy, Controller, as its authorized official.

NPPES Registry Identity

NPI1043424047
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameCEDAR RIDGE, INC
Location Address11400 JULIANNE AVE NStillwater, MN 55082-9436
Mailing Address550 Main StNew Brighton, MN 55112-3271 · (612) 326-7555
Phone(612) 326-7555
Organization SubpartNo
Authorized OfficialValerie BundyController · (612) 326-7555
Enumeration DateMay 9, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1043424047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in MN · 1033826
Definition
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.
11400 JULIANNE AVE N, Stillwater, MN 55082
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2052656

Cedar Ridge Dba Eosis Cedar Ridge · Stillwater, MN
Active · expires Jan 14, 2027
CLIA Number24D2052656
Laboratory TypeTreatment Facility
Certificate Effective DateJanuary 15, 2025
Certificate Expiration DateJanuary 14, 2027
Laboratory DirectorEmily Brunner
Laboratory Phone(612) 454-5000
Laboratory LocationCedar Ridge Dba Eosis Cedar Ridge11400 Julianne Avenue North, Stillwater, MN 55082
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LORI MARIE CARGEN BECKWITH LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (612) 454-2406
MR. MICHAEL J SMITH RPH
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (612) 454-2401
AMBER ROSE HARDTKE LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (612) 454-2076
PATRICIA MILLER MA, LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (651) 426-3300
ASHLEY ANN BECK LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (651) 426-3300
MR. STEVEN ROBERT LEFKOWICH LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (651) 426-3300
STEPHANIE OREEN GILQUIST LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (651) 426-3300
MR. BRETT BAKER LADC
Counselor (Addiction (Substance Use Disorder))
11400 JULIANNE AVE N
STILLWATER, MN 55082
Washington County (651) 426-3300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cedar Ridge, Inc's NPI number?

The NPI number for Cedar Ridge, Inc is 1043424047. It was assigned to this organization in the NPPES registry on May 9, 2007.

Where is Cedar Ridge, Inc located?

Cedar Ridge, Inc is located at 11400 Julianne Ave N, Stillwater, MN 55082. The listed phone number is (612) 326-7555.

What is Cedar Ridge, Inc's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Cedar Ridge, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2052656) is associated with this NPI, valid through January 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cedar Ridge, Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.