PAUL'S PLACE
NPI 1104082114
Substance Abuse Rehabilitation Facility in Farmington, MN
- Organization
- Substance Abuse Rehabilitation Facility
- CLIA Number: 24D2067630
- CLIA Cert. Type: Other - CHEMICAL DEP TREATMENT
- CLIA Exp. Date: 10-20-2025
About PAUL'S PLACE
This page provides the complete NPI Profile along with additional information for Paul's Place, a provider established in Farmington, Minnesota operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1104082114 assigned on July 2008. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Paul's Place. The authorized official of this NPI record is Robert L Haven (President)
- NPI
- 1104082114 Verify this NPI
- Provider Legal Name
- HAVEN CHEMICAL HEALTH SYSTEMS, LLC
- Other Organization Name
- PAUL'S PLACE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 22355 ALBATROSS CIR FARMINGTON, MN 55024
- Location Phone
- (651) 463-2608
- Mailing Address
- 2042 WOODDALE DR SUITE #220 WOODBURY, MN 55125
- Mailing Phone
- (651) 734-9633
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-30-2008
- Last Update Date
- 07-30-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- License State
- MN
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D2067630
- Facility Type
- Other - CHEMICAL DEP TREATMENT
- Certificate Effective Date
- October 21, 2023
- Certificate Expiration Date
- October 20, 2025
- Laboratory Director
- JOHN S. HENDERLITE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Paul's Place to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
FARMINGTON, MN 55024
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104082114, enumerated as an "organization" on July 30, 2008.
The provider is located at 22355 ALBATROSS CIR FARMINGTON, MN 55024 and the phone number is (651) 463-2608.
Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.
