Organization
HAZELDEN BETTY FORD FOUNDATION
Active
Other names
Hazelden Maple Grove
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GIBSON (VP PAYER RELATIONS)
(651) 213-4519
Entity
Organization
Contact information
Practice address
7001 E FISH LAKE RD, WEDGEWOOD OFFICE PARK, MAPLE GROVE, MN 55311-2841
(800) 257-7800
Mailing address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(800) 257-7800
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
800997-5-CDT
MN
Other
Enumeration date
12/13/2010
Last updated
05/16/2025
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