Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nystrom Residential Treatment, LLC

Organization Substance Abuse Rehabilitation Facility · NPI 1386229748

Nystrom Residential Treatment, LLC is a Substance Abuse Rehabilitation Facility in Big Lake, Minnesota. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

19580 Station St
Big Lake, MN 55309-9411
Phone: (763) 309-2021
Fax: (763) 309-2022
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1386229748
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ann Eiden — Vp Of Corporate Services · (651) 379-1750
NPI enumeratedMarch 16, 2021
Last updated in NPPESApril 7, 2025
Certification dateApril 7, 2025
Mailing address1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786