Provider Demographics
NPI:1346933645
Name:NEXUS FAMILY HEALING
Entity Type:Organization
Organization Name:NEXUS FAMILY HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARBLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:763-551-8640
Mailing Address - Street 1:900 189TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:EAST BETHEL
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9542
Mailing Address - Country:US
Mailing Address - Phone:763-551-8640
Mailing Address - Fax:763-553-1637
Practice Address - Street 1:900 189TH AVE NE
Practice Address - Street 2:
Practice Address - City:EAST BETHEL
Practice Address - State:MN
Practice Address - Zip Code:55011-9542
Practice Address - Country:US
Practice Address - Phone:763-551-8640
Practice Address - Fax:763-553-1637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXUS FAMILY HEALING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No273R00000XHospital UnitsPsychiatric Unit
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness