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NPI 1205478849 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Montrose, MN
Provider details
- NPI number
- 1205478849
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Marvin Roseman, Ceo(651) 276-8688
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 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
123 Garner Cir
Montrose, MN 55363-8598
Phone: (651) 276-8688
Street-level locationGet directions
Mailing address
123 Garner Cir
Montrose, MN 55363-8598
Registry dates
- Enumerated
- 2019-10-15
- Last updated
- 2019-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.