TRANSFORMATION HOUSE, INC. (NPI# 1376950469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376950469 |
| Entity Type | Organization |
| Organization Name | TRANSFORMATION HOUSE, INC. |
| Practice Address |
3079 90th Ave Princeton MN 55371-6134 |
| Practice Telephone | 7634267155 |
| Practice Fax Number | 7634276084 |
| Mailing Telephone | 7634267155 |
| Mailing Fax Number | 7634276084 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |
| Authorized Official Name | MS. BETTY JEAN MATHEWS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7634527001 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 10739571CDT | MN | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114143989 | Transformation House, Inc. | Substance Abuse Rehabilitation Facility | 2532 N Ferry St, Anoka, MN 55303-1653 | 2007-04-18 |
| 1508081506 | Transformation House, Inc. | Substance Abuse Rehabilitation Facility | 351 74th Ave Ne, Fridley, MN 55432-3258 | 2007-04-16 |
| 1770708125 | Transformation House, Inc. | Substance Abuse Rehabilitation Facility | 1410 S Ferry Rd, Anoka, MN 55303-2164 | 2007-04-13 |
| Street Address |
3079 90TH AVE |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371-6134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| 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. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134661127 | New Freedom Inc | Substance Abuse Rehabilitation Facility | 1101 5th St N, Princeton, MN 55371-1459 | 2016-11-08 |
| 1477939627 | Sunspire Health Texas LLC | Substance Abuse Rehabilitation Facility | 3800 County Road 444, Princeton, TX 75407-4432 | 2015-08-10 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1194038802 | Caron Foundation of Texas, Inc | Substance Abuse Rehabilitation Facility | 3800 County Road, 444, Princeton, TX 75407-4432 | 2010-07-22 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1851667547 | Rum River Health Services | Substance Abuse Rehabilitation Facility | 1506 1st St, Princeton, MN 55371-1462 | 2012-03-27 |
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|---|---|---|---|---|
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| 1801405584 | Bridge Recovery LLC | Substance Abuse Rehabilitation Facility | 1485 10th Avenue Ne, Sauk Rapids, MN 56379-9838 | 2020-07-28 |
| 1710505821 | Rrecovery Services | Substance Abuse Rehabilitation Facility | 867 Pierce Butler Rte, Saint Paul, MN 55104-1522 | 2020-07-06 |
| 1912520966 | Avenues, LLC | Substance Abuse Rehabilitation Facility | 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 | 2020-05-26 |
| 1962022939 | Valley View Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 31591 64th Ave, Cannon Falls, MN 55009-4296 | 2020-04-20 |
| 1801420039 | Recovery Center LLC | Substance Abuse Rehabilitation Facility | 109 W James St, Paynesville, MN 56362-1216 | 2020-02-26 |
| 1336772425 | Northern Minnesota Addiction Wellness Center | Substance Abuse Rehabilitation Facility | 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 | 2020-02-17 |
| 1386277622 | Community of Recovering People | Substance Abuse Rehabilitation Facility | 1221 Wayzata Blvd E, Wayzata, MN 55391-1942 | 2020-02-14 |
| 1992366645 | One Touch of Christ Evangelistic Ministries | Substance Abuse Rehabilitation Facility | 5701 Shingle Creek Pkwy Ste 650, Brooklyn Center, MN 55430-2492 | 2019-06-24 |
| 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.