MAPLE LAKE RECOVERY CENTER, INC.
NPI 1760587109
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children in Maple Lake, MN
NPI Status: Active since September 13, 2006
Contact Information
207 DIVISION ST. E
MAPLE LAKE, MN
ZIP 55358
Phone: (320) 963-6865
Fax: (320) 963-6279
- Organization
- Substance Abuse Rehabilitation Facility
- Substance Abuse Treatment, Children
- CLIA Number: 24D2240133
- CLIA Cert. Type: School/Student Health Service
- CLIA Exp. Date: 10-17-2027
About MAPLE LAKE RECOVERY CENTER, INC.
This page provides the complete NPI Profile along with additional information for Maple Lake Recovery Center, Inc., a provider established in Maple Lake, Minnesota operating as a Substance Abuse Rehabilitation Facility, focusing in substance abuse treatment, children . The healthcare provider is registered in the NPI registry with number 1760587109 assigned on September 2006. The practitioner's primary taxonomy code is 3245S0500X with license number 810975-1-CRF (MN). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Judith M Feenstra Ladc (Administrator)
- NPI
- 1760587109
- Provider Name
- MAPLE LAKE RECOVERY CENTER, INC.
- Entity Type
- Organization
- Location Address
- 207 DIVISION ST. E MAPLE LAKE, MN 55358
- Location Phone
- (320) 963-6865
- Location Fax
- (320) 963-6279
- Mailing Address
- P O BOX 308 207 DIVISION ST. E MAPLE LAKE, MN 55358
- Mailing Phone
- (320) 963-6865
- Mailing Fax
- (320) 963-6279
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-13-2006
- Last Update Date
- 09-03-2008
- 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 Substance Abuse Treatment, Children
- Taxonomy Code
- 3245S0500X
- Type
- Residential Treatment Facilities
- License No.
- 810975-1-CRF
- License State
- MN
- Taxonomy Description
- A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
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
- 24D2240133
- Facility Type
- School/Student Health Service
- Certificate Effective Date
- October 18, 2025
- Certificate Expiration Date
- October 17, 2027
- Laboratory Director
- AMITY L. DIEBOLD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Maple Lake Recovery Center, Inc. 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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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1760587109, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760587109, enumerated as an "organization" on September 13, 2006.
The provider is located at 207 DIVISION ST. E MAPLE LAKE, MN 55358 and the phone number is (320) 963-6865.
Substance Abuse Rehabilitation Facility with taxonomy code 3245S0500X and a focus in Substance Abuse Treatment, Children.
