HAZELDEN FELLOWSHIP CLUB (NPI# 1578680971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578680971 |
| Entity Type | Organization |
| Organization Name | HAZELDEN FELLOWSHIP CLUB |
| Practice Address |
680 Stewart Ave Saint Paul MN 55102-4117 |
| Practice Telephone | 7635093900 |
| Mailing Telephone | 7635093900 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TERESA HAYDEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7635093910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
680 STEWART AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-4117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801944368 | Mark Jonathan Sanstead | Psychologist | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2007-01-08 |
| 1881225647 | Benjamin Atkinson Currier Iv | Counselor | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2020-01-30 |
| 1518503002 | Amy L Conlon | Psychologist | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2019-11-20 |
| 1164066536 | Hyun-soo Lee | Psychologist | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2019-10-29 |
| 1821575531 | Ashley Stendahl | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2018-07-25 |
| 1699251827 | Susan Slocum O'connor | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102 | 2018-07-11 |
| 1023542461 | Stephanie Ann Johnson | Counselor | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2017-04-12 |
| 1366973257 | Michael James Tkach | Psychologist | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2017-03-23 |
| 1396288577 | Rose Solly | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2016-11-21 |
| 1770034134 | Johnna Ann Vanboxel | Registered Nurse | 680 Stewart Ave, Saint Paul, MN 55102-4117 | 2016-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| 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 |
|---|---|---|---|---|
| 1730791393 | Crecer Services | Substance Abuse Rehabilitation Facility | 220 Robert St S Ste 103, Saint Paul, MN 55107-1626 | 2020-08-17 |
| 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 |
| 1376076604 | North Point Health &wellness Center | Substance Abuse Rehabilitation Facility | 950 Sherburne Ave, Saint Paul, MN 55104-2606 | 2017-04-04 |
| 1871931535 | Volunteers of America | Substance Abuse Rehabilitation Facility | 1394 Jackson St, Saint Paul, MN 55117-4629 | 2013-06-04 |
| 1780850446 | Volunteers of America of Minnesota | Substance Abuse Rehabilitation Facility | 5100 Hodgson Rd, Saint Paul, MN 55126-1229 | 2008-05-02 |
| 1649440355 | Juel Fairbanks Chemical Dependency Services | Substance Abuse Rehabilitation Facility | 806 Albert St N, Saint Paul, MN 55104-1303 | 2008-03-10 |
| 1588878599 | Tapestry, LLC | Substance Abuse Rehabilitation Facility | 1609 Jackson St, Saint Paul, MN 55117-3917 | 2007-05-09 |
| 1689708083 | Twin Town Treatment Center | Substance Abuse Rehabilitation Facility | 1706 University Ave W, Saint Paul, MN 55104-3614 | 2007-03-15 |
| 1154455533 | Avalon Programs, LLC | Substance Abuse Rehabilitation Facility | 1885 University Avenue West, Suite 151, Saint Paul, MN 55104 | 2007-03-15 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55102 |
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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.