Organization
TRANSITIONS HOMES CORPORATION
Active
Organization
TRANSITIONS HOMES CORPORATION
Active
Other names
Transitions Outpatient Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JERRY MUGAAS (EXECUTIVE DIRECTOR)
(612) 819-7207
Entity
Organization
Contact information
Practice address
366 PRIOR STREET, SUITE #205, ST. PAUL, MN 55104
(651) 644-1304
(888) 239-3133
Mailing address
1450 N WILLOW DR, LONG LAKE, MN 55356-9568
(612) 819-7207
(888) 239-3133
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
1055581
MN
Other
Enumeration date
02/08/2010
Last updated
02/08/2010
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