MINNESOTA TEEN CHALLENGE, INC. (NPI# 1285057539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285057539 |
| Entity Type | Organization |
| Organization Name | MINNESOTA TEEN CHALLENGE, INC. |
| Other Organization Name | MINNESOTA ADULT & TEEN CHALLENGE |
| Practice Address |
1530 Assisi Dr Nw Rochester MN 55901 |
| Mailing Address |
1619 Portland Ave S Minneapolis MN 55404 |
| Practice Telephone | 5072883733 |
| Practice Fax Number | 8552888560 |
| Mailing Telephone | 6123733366 |
| Mailing Fax Number | 6123334111 |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2020-08-06 |
| Authorized Official Name | MR. MICHAEL WILLIAM MAHONEY (TREATMENT DIRECTOR) |
| Authorized Official Telephone | 5072183450 |
| Authorized Official Credential | LADC, NCAC1 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 302F00000X | Exclusive Provider Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Minnesota Adult & Teen Challenge | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 40 16th St Se Ste E, Rochester, MN 559047987 | 6123733366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831574797 | Minnesota Teen Challenge, Inc. | Counselor | 740 E 24th St, Minneapolis, MN 55404 | 2015-07-21 |
| 1235514118 | Minnesota Teen Challenge, Inc. | Exclusive Provider Organization | 100 Garrison Ave Ne, Buffalo, MN 55313 | 2015-07-21 |
| 1538325980 | Minnesota Teen Challenge, Inc. | Substance Abuse Rehabilitation Facility | 1 East 1st Street, Duluth, MN 55802 | 2008-08-05 |
| 1932278538 | Minnesota Teen Challenge, Inc. | Substance Abuse Rehabilitation Facility | 1717 2nd Ave S, Minneapolis, MN 55403 | 2006-11-07 |
| 1194802710 | Minnesota Teen Challenge, Inc. | Substance Abuse Rehabilitation Facility | 3231 1st Ave S, Minneapolis, MN 55408-4407 | 2006-11-01 |
| 1154977056 | Minnesota Teen Challenge, Inc. | Substance Abuse Rehabilitation Facility | 2756 Douglas Dr N, Crystal, MN 55422-2402 | 2019-08-15 |
| Street Address |
1530 ASSISI DR NW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548225188 | Samaritan Bethany Inc | Skilled Nursing Facility | 1530 Assisi Dr Nw, Rochester, MN 55901-1637 | 2006-04-18 |
| 1699214890 | Carl White | Counselor | 1530 Assisi Dr Nw, Rochester, MN 55901-1637 | 2017-02-21 |
| 1831519081 | Kenton Neu | Counselor | 1530 Assisi Dr Nw, Rochester, MN 55901-1637 | 2014-04-25 |
| 1639597511 | Joy Kubinski | Counselor | 1530 Assisi Dr Nw, Rochester, MN 55901-1637 | 2014-03-28 |
| 1659799500 | Michael William Mahoney | Counselor | 1530 Assisi Dr Nw, Rochester, MN 55901-1637 | 2014-03-28 |
| 1992095319 | Diann Irene Renaas | Counselor | 1530 Assisi Dr Nw, Rochester, MN 55901 | 2011-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1497303150 | Tatenda Valentine Rudziva | Nurse Practitioner | 2989 315 Elton Hills Drive Nw, Suite 201, Rochester, MN 55901 | 2019-08-27 |
| 1629566872 | Juan Simon Rico Mesa | Student in an Organized Health Care Education/Training Program | 4502 Medical Drive, San Antonio, 78229, San Antonio, TX 55901 | 2018-04-24 |
| 1336658277 | Minnesota Teen Challenge | Exclusive Provider Organization | 1542 Assisi Drive Nw, Rochester, MN 55901 | 2017-09-22 |
| 1235648270 | Mariah Adanene | Registered Nurse | 915 41st Street Nw, Rochester, MN 55901 | 2017-09-21 |
| 1912420639 | Anna Maria Schuman | Speech-Language Pathologist | 2746 Superior Drive Nw, Suite Number 150, Rochester, MN 55901 | 2017-07-25 |
| 1871013870 | Rhonda Keith | Counselor | 602 11th Avenue Nw #300, Rochester, MN 55901 | 2017-06-21 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1659810844 | Rx Team Home Health Care LLC | Home Health | 1027 7th St Nw Unit #204, Rochester, MN 55901 | 2017-02-21 |
| 1457713109 | Joshua Carter | Chiropractor | 3270 19th St Nw Ste 203, Rochester, MN 55901 | 2016-03-22 |
| Find all providers in zip 55901 | ||||
| Taxonomy Code | 302F00000X |
| Grouping | Managed Care Organizations |
| Classification | Exclusive Provider Organization |
| (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations. |
| Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 15; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58; (3) Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659862290 | Mitchell J Lurye,lcswr.llc | Exclusive Provider Organization | 274 N Goodman St Ste 283, Rochester, NY 14607-1154 | 2018-05-18 |
| 1336658277 | Minnesota Teen Challenge | Exclusive Provider Organization | 1542 Assisi Drive Nw, Rochester, MN 55901 | 2017-09-22 |
| 1518398106 | Braces of Greece | Exclusive Provider Organization | 770 Fetzner Rd., Rochester, NY 14626 | 2013-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578099966 | Citywide Home Care LLC | Exclusive Provider Organization | 322 S 2nd St, Suite 205, Minneapolis, MN 55401-3828 | 2017-05-04 |
| 1912440256 | Halbur/witham, LLC | Exclusive Provider Organization | 2623 125th St Ne, Rice, MN 56367-9746 | 2016-11-18 |
| 1962958611 | Centracare Clinic | Exclusive Provider Organization | 166 19th Street S, Suite 202, Sartell, MN 56377 | 2016-08-31 |
| 1760837082 | Kathryn Pearson-brevik | Exclusive Provider Organization | 6483 Heritage Trl, Gilbert, MN 55741-8029 | 2016-04-25 |
| 1427415249 | Waano Foundation | Exclusive Provider Organization | 393 Dunlap St N Ste 400k, Saint Paul, MN 55104-4235 | 2016-01-25 |
| 1538534037 | Community Care Services LLC | Exclusive Provider Organization | 1070 Henslow Ave N, Oakdale, MN 55128-5858 | 2015-12-09 |
| 1235514118 | Minnesota Teen Challenge, Inc. | Exclusive Provider Organization | 100 Garrison Ave Ne, Buffalo, MN 55313 | 2015-07-21 |
| 1407249477 | Infinite Health Collaborative, Pa | Exclusive Provider Organization | 6754 Valley View Rd, Edina, MN 55439-1761 | 2015-03-14 |
| 1841698339 | Kingdom In Action | Exclusive Provider Organization | 9500 Minnetonka Blvd, St Louis Park, MN 55426-2944 | 2014-12-15 |
| 1356745681 | Sonder Chiropractic, P.a. | Exclusive Provider Organization | 1049 Comstock Dr, 107, Deer River, MN 56636-9708 | 2014-10-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.