Organization
CCRI, INC
Active
Other names
Creative Care for Reaching Independence
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON BOCK (EXECUTIVE DIRECTOR)
(218) 236-6730
Entity
Organization
Contact information
Practice address
2903 15TH ST S, MOORHEAD, MN 56560-5111
(218) 236-6730
(218) 236-1481
Mailing address
2903 15TH ST S, MOORHEAD, MN 56560-5111
(218) 236-6730
(218) 236-1481
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
MN
251S00000X
Community/Behavioral Health Agency
—
MN
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
MN
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
800502
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001418000
—
MN
05
—
304720200
—
MN
05
—
403445700
—
MN
05
—
409343700
—
MN
05
—
702420000
—
MN
Enumeration date
02/21/2007
Last updated
08/13/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up