New Salem Metamorphosis Adolesent Program

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1061325-1-CDT Issued in MN

Legal business name

NEW SALEM METAMORPHOSIS ADOLESENT PROGRAM

Practice address

2507 Bryant Ave N
Minneapolis, MN 55411-2116

Phone

(612) 250-8799

NPI assigned

Jul 14, 2012

Organization subpart

No

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

Authorized official

Name

Hortense Jones, AA

Title

Program Administrator

Phone

(612) 250-8799

Specialties & licenses 2

Addresses

Tax ID family

New Salem Metamorphosis Adolesent Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• New Salem Metormorphosis Youth Program

  • Addiction (Substance Use Disorder) Counselor
  • Minneapolis, MN
  • NPI 1720354004
  NPD tax ID

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

{
    "created_epoch": "1342224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342224000000",
    "number": "1750636973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112116",
            "telephone_number": "612-250-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554112116",
            "telephone_number": "612-250-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SALEM METAMORPHOSIS ADOLESENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-14",
        "last_updated": "2012-07-14",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "HORTENSE",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "612-250-8799",
        "authorized_official_credential": "AA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1061325-1-CDT",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Diagnosis LLC
• New Horizon Therapy Center LLC
• New Horizons Health Center
• New Millennium Academy
• New Minnesota Purpose of Freedom
• New Salem Metormorphosis Youth Program
• New Salem Missionary Baptist Church
• New Vision Mental Health Inc
• New Visions School
• New Youth Program

• Addiction (Substance Use Disorder) Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2012; 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.