OrganizationActive
Family Based Therapy Associates
NPI 1891100293 · Community/Behavioral Health Agency · Chisago City, MN
Provider details
- NPI number
- 1891100293
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Randall Wallace, Director(763) 780-1520
- License
- 00789 (MN)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
11549 Lake Ln
Suite 2
Chisago City, MN 55013-9830
Phone: (651) 257-2733
Fax: (651) 257-2783
Street-level locationGet directions
Mailing address
199 Coon Rapids Blvd Nw
Coon Rapids, MN 55433-5831
Registry dates
- Enumerated
- 2014-06-24
- Last updated
- 2014-06-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.