Organization
MINNESOTA TEEN CHALLENGE, INC.
Active
Other names
Minnesota Teen Challenge
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE BEAULIEU (BILLING MANAGER)
(763) 257-5301
Entity
Organization
Contact information
Practice address
1717 2ND AVE S, MINNEAPOLIS, MN 55403
(612) 373-3366
(612) 333-4111
Mailing address
740 E 24TH ST, MINNEAPOLIS, MN 55404
(612) 373-3366
(612) 333-4111
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
10090493CDT
MN
Other
Enumeration date
11/07/2006
Last updated
03/15/2021
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