NPIMap

Organization Active NPI

Transformation House, Inc.

Doing business as Recovery Hub

  • Substance Abuse Rehabilitation Facility
  • Anoka, MN
National Provider Identifier
1770708125
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
803826-1-CDT Issued in MN
Legal business name
TRANSFORMATION HOUSE, INC.
Doing business as
Recovery Hub
Practice address
1410 S Ferry Rd
Anoka, MN 55303-2164
Phone
(763) 427-7155
Fax
(763) 427-6084
NPI assigned
Apr 13, 2007
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 803826-1-CDT MN Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

1410 S Ferry Rd
Anoka, MN 55303-2164

Mailing address

1410 S Ferry Rd
Anoka, MN 55303-2164
Phone (763) 427-7155

Other identifiers 1

IdentifierTypeStateIssuer
719055700OtherMNMHCP PROVIDER NUMBER

Other names 1

  • Recovery Hub Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230711002876 MN Part B Supplier - Clinic/Group Practice 1850750696 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anoka, MN; Fridley, MN

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
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.

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": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1770708125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S FERRY RD",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032164",
            "telephone_number": "763-427-7155",
            "fax_number": "763-427-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S FERRY RD",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553032164",
            "telephone_number": "763-427-7155",
            "fax_number": "763-427-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "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": "803826-1-CDT",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP PROVIDER NUMBER",
            "identifier": "719055700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery Hub",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anoka, MN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.