NPI 1336658277

Minnesota Teen Challenge

Organisation Substance Abuse Rehabilitation Facility Rochester, MN

Practice location

Address: 1542 Assisi Drive NW, Rochester, MN 55901
Phone: (612) 373-3366
Fax: (612) 333-4111
Mailing address: 740 E 24th St, Minneapilis, MN 55404

Authorised official

Name: Debra Rae Warner
Title: Billing Manager
Phone: (612) 238-6528

Registered specialties (2)

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

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Exclusive Provider Organization

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1336658277
Entity type: Organization
NPI issued: 22 Sep 2017
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.