NPIMap

Organization Active NPI

Minnesota Teen Challenge, Inc

  • Substance Abuse Rehabilitation Facility
  • Brainerd, MN
National Provider Identifier
1528360591
Registry record updated Mar 14, 2022
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
2424 Business 371
Brainerd, MN 56401-8306
Phone
(218) 833-8777
Fax
(218) 833-8778
NPI assigned
Nov 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 1056824-1-CDT MN
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

2424 Business 371
Brainerd, MN 56401-8306

Mailing address

2424 Business 371
Brainerd, MN 56401-8306
Phone (218) 833-8777

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.

Locations

2424 Business 371
Brainerd, MN 56401
Phone (218) 833-8777

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1528360591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 BUSINESS 371",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018306",
            "telephone_number": "218-833-8777",
            "fax_number": "218-833-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 BUSINESS 371",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564018306",
            "telephone_number": "218-833-8777",
            "fax_number": "218-833-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA TEEN CHALLENGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "BEAULIEU",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "INSURANCE REPRESENTATIVE",
        "authorized_official_telephone_number": "763-257-5301"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MN",
            "license": "1056824-1-CDT",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.