OrganizationActive
Jacy1 Dba Anchorage
NPI 1508044975 · Substance Abuse Rehabilitation Facility · Moorhead, MN
Provider details
- NPI number
- 1508044975
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Laurie Ray, Program Director(218) 287-1500
- License
- 1044799 (MN)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
810 4th St S
Suite 152
Moorhead, MN 56560
Phone: (218) 287-1500
Fax: (218) 287-1267
Street-level locationGet directions
Mailing address
810 4th St S
Moorhead, MN 56560
Registry dates
- Enumerated
- 2008-02-07
- Last updated
- 2008-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.