NPIMap

Organization Active NPI

Minnesota Teen Challenge, Inc

  • Substance Abuse Rehabilitation Facility
  • Buffalo, MN
National Provider Identifier
1003662420
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MINNESOTA TEEN CHALLENGE, INC
Practice address
8150 20TH St SE
Buffalo, MN 55313-4640
Phone
(612) 373-3366
NPI assigned
Apr 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephanie Beaulieu
Title
Contract Representative
Phone
(763) 257-5301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

8150 20TH St SE
Buffalo, MN 55313-4640

Mailing address

740 E 24TH St
Minneapolis, MN 55404-3862

Other names 1

  • Rockbridge Treatment and Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Teen Challenge13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1003662420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 20TH ST SE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553134640",
            "telephone_number": "612-373-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA TEEN CHALLENGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "BEAULIEU",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CONTRACT REPRESENTATIVE",
        "authorized_official_telephone_number": "763-257-5301"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockbridge Treatment and Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buffalo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.