Organization
TRANSFORMATION HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTIAN CHIESA (CEO)
(763) 452-7011
Entity
Organization
Contact information
Practice address
361 74TH AVE NE, FRIDLEY, MN 55432-3258
(763) 427-7155
Mailing address
1410 S FERRY ST, ANOKA, MN 55303-2152
(763) 426-7155
(763) 427-6084
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
10739571CDT
MN
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
07/21/2014
Last updated
02/28/2024
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