CMS-1500 Box 24J / 33a • NPI
1447972005
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
101YA0400X
Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)
Box 32 Service Location & ZIP+4
181 N MADDY ST, MCGREGOR, MN, 55760-1410
✓ 9-Digit EDI 837 ZIP+4 (55760-1410)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1447972005 (LIFELONG RECOVERY CENTER, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1447972005 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | LIFELONG RECOVERY CENTER, LLC |
| Plain-English Specialty | Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) NUCC Code: 101YA0400X (Counselor, Addiction (Substance Use Disorder)) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 181 N MADDY ST, MCGREGOR, MN, 55760-1410 |
| Practice Telephone / Fax | Tel: (218) 391-6560 |
| Administrative Mailing Address | PO BOX 218, MCGREGOR, MN, 55760-0218 |
| Enumeration & Last Sync | Enumerated: 2022-09-12 | CMS Record Updated: 2022-09-12 |
| Authorized Official | JENNIFER MCINTOSH (Director) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (101YA0400X)
What Does Taxonomy Code 101YA0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YA0400X translates to:
"Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LIFELONG RECOVERY CENTER, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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