OrganizationActive
Nystrom Residential Treatment, LLC
NPI 1386229748 · Substance Abuse Rehabilitation Facility · Big Lake, MN
Provider details
- NPI number
- 1386229748
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Ann Eiden, Vp of Corporate Services(651) 379-1750
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
19580 Station St
Big Lake, MN 55309-9411
Phone: (763) 309-2021
Fax: (763) 309-2022
Street-level locationGet directions
Mailing address
1900 Silver Lake Rd Nw
New Brighton, MN 55112-1786
Registry dates
- Enumerated
- 2021-03-16
- Last updated
- 2025-04-07
- Certified
- 2025-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.