Transformation House, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

10739571CDT Issued in MN

Legal business name

TRANSFORMATION HOUSE, INC.

Practice address

361 74TH Ave NE
Fridley, MN 55432-3258

Phone

(763) 427-7155

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Cristian Chiesa

Title

Ceo

Phone

(763) 452-7011

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Transformation House Inc

  • Mental Health Counselor
  • Anoka, MN
  • NPI 1417768771

  O20230711002876

  Same enrollment
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Anoka, MN
  • NPI 1114143989

  O20230711002876

  Same enrollment
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Fridley, MN
  • NPI 1508081506

  O20230711002876

  Same enrollment
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Anoka, MN
  • NPI 1770708125

  O20230711002876

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Transformation House Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Transformation House Inc

  • Mental Health Counselor
  • Anoka, MN
  • NPI 1417768771
  NPD tax ID
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Anoka, MN
  • NPI 1114143989
  NPD tax ID
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Fridley, MN
  • NPI 1508081506
  NPD tax ID
• Transformation House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Anoka, MN
  • NPI 1770708125
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roxanne Jo Dobrava, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hutchinson, MN
  • NPI 1336700491
  NPD
• Katharine Gelecinskyj

  • Mental Health Counselor
  • Bloomington, MN
  • NPI 1912622440
  NPD
• Christina Renee Richardson, APRN, FNP-BC

  • Family Nurse Practitioner
  • Northfield, MN
  • NPI 1336803691
  NPD

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1376950469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S FERRY ST",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032152",
            "telephone_number": "763-426-7155",
            "fax_number": "763-427-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 74TH AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323258",
            "telephone_number": "763-427-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "CHIESA",
        "authorized_official_first_name": "CRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-452-7011"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "10739571CDT",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Touchstone Mental Health
• Dang Duy Tran, M.D.
• Michael Long Tran, M.D.
• Trans Home Care Services
• Transform Lives LLC
• Transformation House, Inc.
• Aaron Joseph Trnka, M.A., LMFT
• Sara Marie Troje, P.T.
• Truehome Care Inc
• Trustier Home Health

• Substance Abuse Rehabilitation Facility in Fridley, MN
• Providers in Fridley, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.