| Transitions Outpatient Program | |
|
366 Prior Street Suite #205 St. Paul MN 55104 | |
| (651) 644-1304 | |
| (888) 239-3133 |
| Full Name | Transitions Outpatient Program |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 366 Prior Street, St. Paul, Minnesota |
| Authorized Official Name and Position | Michael Jerry Mugaas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6128197207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitions Outpatient Program 1450 N Willow Dr Long Lake MN 55356-9568 Ph: (612) 819-7207 | Transitions Outpatient Program 366 Prior Street Suite #205 St. Paul MN 55104 Ph: (651) 644-1304 |
| NPI Number | 1992037535 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 02/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992037535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 1055581 (Minnesota) | Primary |
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