OrganizationActive
Jacy, LLC
NPI 1093927998 · Mental Illness Community Based Residential Treatment Facility · Cold Spring, MN
Provider details
- NPI number
- 1093927998
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Carmen Wilson, Owner(320) 255-9530
- License
- 1043554-2-AFC (MN)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense 1043554-2-AFC (MN)
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
616 Emmas Dr Se
Cold Spring, MN 56320-1454
Phone: (320) 685-4578
Street-level locationGet directions
Mailing address
600 25th Ave S
Saint Cloud, MN 56301-4841
Other names (DBA / former)
- Doing business as
- Stoneridge
Registry dates
- Enumerated
- 2007-05-04
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.