Provider Demographics
NPI:1093162232
Name:NEXUS FAMILY HEALING
Entity Type:Organization
Organization Name:NEXUS FAMILY HEALING
Other - Org Name:NEXUS-MILLE LACS FAMILY HEALING
Other - Org Type:Other Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-551-8640
Mailing Address - Street 1:407 130TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:56359-3115
Mailing Address - Country:US
Mailing Address - Phone:320-532-4005
Mailing Address - Fax:320-532-4898
Practice Address - Street 1:312 ELM ST S
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:56359-4013
Practice Address - Country:US
Practice Address - Phone:320-532-4005
Practice Address - Fax:320-532-4898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness