Organization
HAZELDEN BETTY FORD FOUNDATION
Active
Parent organization
HAZELDEN BETTY FORD FOUNDATION
Other names
Hazelden Menasha
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAZELDEN BETTY FORD FOUNDATION
Authorized official
ASHLEY GIBSON (VP PAYER RELATIONS)
(651) 213-4519
Entity
Organization
Contact information
Practice address
677 BRIGHTON BEACH RD, MENASHA, WI 54952-2903
(800) 257-7800
Mailing address
15251 PLEASANT VALLEY RD, CENTER CITY, MN 55012-9640
(651) 213-4881
(651) 213-4793
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
—
—
Other
Enumeration date
09/14/2022
Last updated
08/06/2025
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