Organization
MINNESOTA TEEN CHALLENGE
Active
Organization
MINNESOTA TEEN CHALLENGE
Active
Other names
Minnesota Adult & Teen Challenge
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA RAE WARNER (BILLING MANAGER)
(612) 238-6528
Entity
Organization
Contact information
Practice address
1542 ASSISI DRIVE NW, ROCHESTER, MN 55901
(612) 373-3366
(612) 333-4111
Mailing address
740 E 24TH ST, MINNEAPILIS, MN 55404
(612) 373-3366
(612) 333-4111
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
MN
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/22/2017
Last updated
03/14/2022
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