NPIMap

Organization Active NPI

Hazelden Betty Ford Foundation

Doing business as Hazelden Chaska

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chaska, MN
National Provider Identifier
1104194208
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HAZELDEN BETTY FORD FOUNDATION
Doing business as
Hazelden Chaska
Practice address
1107 Hazeltine Blvd Ste 300
Chaska, MN 55318-1065
Phone
(800) 257-7800
NPI assigned
Dec 5, 2011
Last updated
May 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Ashley Gibson
Title
VP Payer Relations
Phone
(651) 213-4519

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1107 Hazeltine Blvd Ste 300
Chaska, MN 55318-1065

Mailing address

15251 Pleasant Valley Rd
Center City, MN 55012-9640
Phone (800) 257-7800

Other names 1

  • Hazelden Chaska Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hazelden Betty Ford Foundation16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1104194208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15251 PLEASANT VALLEY RD",
            "city": "CENTER CITY",
            "state": "MN",
            "postal_code": "550129640",
            "telephone_number": "800-257-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 HAZELTINE BLVD STE 300",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181065",
            "telephone_number": "800-257-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZELDEN BETTY FORD FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "VP PAYER RELATIONS",
        "authorized_official_telephone_number": "651-213-4519"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hazelden Chaska",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chaska, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.