NPIMap

Organization Active NPI

Minnesota Teen Challenge, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
National Provider Identifier
1831574797
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MINNESOTA TEEN CHALLENGE, INC
Practice address
3231 1St Ave S
Minneapolis, MN 55408-4407
Phone
(612) 373-3366
NPI assigned
Jul 21, 2015
Organization subpart
Yes
Parent organization
MINNESOTA TEEN CHALLENGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Authorized official

Name
Sadie Twite
Title
Revenue Cycle Director
Phone
(612) 373-3366

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3231 1St Ave S
Minneapolis, MN 55408-4407

Mailing address

740 E 24TH St
Minneapolis, MN 55404
Phone (612) 373-3366

Other names 1

  • Minnesota Adult & Teen Challenge Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address info@mntc.org
Direct Messaging Address info@mntc.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230517002547 MN Part B Supplier - Clinic/Group Practice 0840656856 Receives reassigned benefits from 34 practitioners
Practice locations: Crystal, MN; Minnetonka, MN; Maplewood, MN

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Teen Challenge13 organizations share this tax ID, including this one
Part of
Minnesota Teen Challenge

Other organizations with this tax ID 12

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

Locations

2000 Plymouth Rd
Ste 300
Minnetonka, MN 55305
Phone (612) 360-6466

2365 Ariel St N
Saint Paul, MN 55109
Phone (612) 777-8987

Practitioners & affiliated clinicians

Practitioners 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1831574797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-373-3366",
            "fax_number": "612-333-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 1ST AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084407",
            "telephone_number": "612-373-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA TEEN CHALLENGE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA TEEN CHALLENGE, INC.",
        "enumeration_date": "2015-07-21",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "TWITE",
        "authorized_official_first_name": "SADIE",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "612-373-3366"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mntc.org",
            "affiliation": "N",
            "address_1": "3231 1st Ave S",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554084407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mntc.org",
            "affiliation": "N",
            "address_1": "3231 1st Ave S",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554084407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Minnesota Adult & Teen Challenge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.