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Organization

MINNESOTA TEEN CHALLENGE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE BEAULIEU (INSURANCE REPRESENTATIVE)
(763) 257-5301
Entity
Organization

Contact information

Practice address
2424 BUSINESS 371, BRAINERD, MN 56401-8306
(218) 833-8777
(218) 833-8778
Mailing address
2424 BUSINESS 371, BRAINERD, MN 56401-8306
(218) 833-8777
(218) 833-8778

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
1056824-1-CDT
MN
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
11/24/2010
Last updated
03/14/2022
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