Provider Demographics
NPI:1427006048
Name:NEXUS FAMILY HEALING
Entity Type:Organization
Organization Name:NEXUS FAMILY HEALING
Other - Org Name:NEXUS-ONARGA FAMILY HEALING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FINANCIAL PLANNING
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-551-8664
Mailing Address - Street 1:505 HIGHWAY 169 N
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-6434
Mailing Address - Country:US
Mailing Address - Phone:763-551-8640
Mailing Address - Fax:763-553-1637
Practice Address - Street 1:110 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:ONARGA
Practice Address - State:IL
Practice Address - Zip Code:60955-1213
Practice Address - Country:US
Practice Address - Phone:815-268-4001
Practice Address - Fax:815-268-7977
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
IL14239507322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL411419065646Medicaid
IL411419065658Medicaid
IL411419065653Medicaid
IL411419065654Medicaid
IL411419065671Medicaid
IL411419065698Medicaid
IL411419065655Medicaid
IL411419065670Medicaid
IL411419065680Medicaid
IL411419068710Medicaid
IL411419065850Medicaid
IL3B00-IPI-007Medicaid
IL411419065800Medicaid
IL411419065660Medicaid
IL411419065674Medicaid
IL411419065656Medicaid
IL411419065706Medicaid