NPI 1285057539

Minnesota Teen Challenge, INC.

Organisation Substance Abuse Rehabilitation Facility Rochester, MN

Practice location

Address: 1530 Assisi Dr NW, Rochester, MN 55901
Phone: (507) 288-3733
Fax: (855) 288-8560
Mailing address: 1619 Portland Ave S, Minneapolis, MN 55404

Authorised official

Name: Michael William Mahoney
Title: Treatment Director
Phone: (507) 218-3450

Registered specialties (3)

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

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Addiction (Substance Use Disorder) Counselor

Behavioral Health & Social Service Providers Taxonomy 101YA0400X

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Exclusive Provider Organization

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1285057539
Entity type: Organization
NPI issued: 22 Jan 2014
Record last updated: 14 Mar 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.