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Transformation House, Inc.
Adult Health Nurse Practitioner in Fridley, Minnesota
NPI 1508081506

Transformation House, Inc. is an Adult Health Nurse Practitioner based in Anoka, MN and is specialized in Adult Health. Transformation House, Inc. practices in Fridley, MN. The NPI Number for Transformation House, Inc. is 1508081506 and holds a License No. 807288-3-CDT (Minnesota).

The current practice location address for Transformation House, Inc. is 351 74Th Ave Ne, Fridley, MN and can be reached out via phone at 763-786-8172.

Location: 351 74Th Ave Ne, Fridley, MN, 55303-2164
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1508081506
Provider Name
Transformation House, Inc.
Credential
Provider Entity Type
Organization
Address
351 74Th Ave Ne, Fridley, MN, 55303-2164
Phone Number
763-786-8172
Fax Number
Provider Enumeration Date
04/16/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
268217600 01 MN PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
351 74Th Ave Ne
City
Fridley
State
Minnesota
Zip
55432-3258
Phone Number
763-786-8172
Fax Number
person
Provider Business Mailing Address Details
Address
351 74Th Ave Ne
City
Fridley
State
Minnesota
Zip
55432-3258
Phone Number
763-786-8172
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
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Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
807288-3-CDT (Minnesota)
Definition
Definition to come...
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