1. Home
  2. Directory
  3. Minnesota
  4. Big Lake
  5. Substance Abuse Rehabilitation Facility
  6. NPI Profile

NYSTROM RESIDENTIAL TREATMENT, LLC
NPI 1386229748
Substance Abuse Rehabilitation Facility in Big Lake, MN

Active since March 16, 2021
19580 STATION ST, BIG LAKE, MN 55309(763) 309-2021(763) 309-2022 Get Directions Write a Review

NPPES record last updated: April 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 7, 2025, Mar 16, 2021 (2 updates tracked since 2021).

About Nystrom Residential Treatment, Llc NPPES

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

NYSTROM RESIDENTIAL TREATMENT, LLC (NPI 1386229748) is a healthcare organization registered as a substance abuse rehabilitation facility in Big Lake, Minnesota and active in the NPI registry since March 2021. The organization lists Ann Eiden, Vp Of Corporate Services, as its authorized official.

NPPES Registry Identity

NPI1386229748
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameNYSTROM RESIDENTIAL TREATMENT, LLC
Location Address19580 STATION STBig Lake, MN 55309-9411
Mailing Address1900 Silver Lake Rd NwNew Brighton, MN 55112-1786 · (651) 628-9566 · Fax (651) 628-0411
Phone(763) 309-2021
Fax(763) 309-2022
Organization SubpartNo
Authorized OfficialAnn EidenVp Of Corporate Services · (651) 379-1750
Enumeration DateMarch 16, 2021
Last NPPES UpdateApril 7, 20252 updates tracked since enumeration
NPPES CertifiedApril 7, 2025
✔ NPI 1386229748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
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.
19580 STATION ST, Big Lake, MN 55309
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Other Providers at the Same Location NPPES 2

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

JANICE C REKER
Counselor (Addiction (Substance Use Disorder))
19580 STATION ST
BIG LAKE, MN 55309
Sherburne County (844) 939-3125
ASHLEY RAE KASHEVAROFF
Counselor (Addiction (Substance Use Disorder))
19580 STATION ST
BIG LAKE, MN 55309
Sherburne County (612) 850-5567

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 Nystrom Residential Treatment, LLC's NPI number?

The NPI number for Nystrom Residential Treatment, LLC is 1386229748. It was assigned to this organization in the NPPES registry on March 16, 2021.

Where is Nystrom Residential Treatment, LLC located?

Nystrom Residential Treatment, LLC is located at 19580 Station St, Big Lake, MN 55309. The listed phone number is (763) 309-2021.

What is Nystrom Residential Treatment, LLC's specialty?

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

What insurance does Nystrom Residential Treatment, LLC accept?

Health plans from Sanford Health Plan list Nystrom Residential Treatment, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nystrom Residential Treatment, LLC was last updated on April 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.