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TRANSFORMATION HOUSE INC. NPI 1114143989


NPI Information

NPI: 1114143989
Provider Name: TRANSFORMATION HOUSE, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 24D2184066

Address:
2532 N FERRY ST
ANOKA, MN
ZIP 55303
Phone: (763) 421-4665
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TRANSFORMATION HOUSE, INC. is a substance abuse rehabilitation facility in Anoka, MN. The provider is 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. TRANSFORMATION HOUSE, INC. NPI is 1114143989. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2532 N FERRY ST
ANOKA, MN
ZIP 55303-653
Phone: (763) 421-4665

The provider's authorized official is Cristian J Chiesa .
The authorized official title is Owner and has the following contact phone number (763) 427-7155.

The CLIA number assigned to this NPI record is 24D2184066 - other - substance abuse treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 6/20/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthNo
2324500000XSubstance Abuse Rehabilitation Facility804982-1-CDTMINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300357400OTHERMINNESOTAPROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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