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Transformation House, Inc.
Adult Health Nurse Practitioner in Anoka, Minnesota
NPI 1770708125

Transformation House, Inc. is an Adult Health Nurse Practitioner based in Anoka, MN and is specialized in Adult Health. Transformation House, Inc. practices in Anoka, MN. The NPI Number for Transformation House, Inc. is 1770708125 and holds a License No. 803826-1-CDT (Minnesota).

The current practice location address for Transformation House, Inc. is 1410 S Ferry Rd, Anoka, MN and can be reached out via phone at 763-427-7155 and via fax at 763-427-6084.

Location: 1410 S Ferry Rd, Anoka, MN, 55303-2164
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1770708125
Provider Name
Transformation House, Inc.
Credential
Provider Entity Type
Organization
Address
1410 S Ferry Rd, Anoka, MN, 55303-2164
Phone Number
763-427-7155
Fax Number
763-427-6084
Provider Enumeration Date
04/13/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
719055700 01 MN MHCP PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
1410 S Ferry Rd
City
Anoka
State
Minnesota
Zip
55303-2164
Phone Number
763-427-7155
Fax Number
763-427-6084
person
Provider Business Mailing Address Details
Address
1410 S Ferry Rd
City
Anoka
State
Minnesota
Zip
55303-2164
Phone Number
763-427-7155
Fax Number
763-427-6084
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.
803826-1-CDT (Minnesota)
Definition
Definition to come...
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