Organization · NPI-2
Hazelden Betty Ford Foundation
Substance Abuse Rehabilitation Facility · Plymouth, MN
NPI number1831216225
StatusActive
Last updated in NPPESMay 16, 2025
Details
- NPI
- 1831216225
- Entity type
- Organization (NPI-2)
- Legal business name
- Hazelden Betty Ford Foundation
- Organization subpart
- No
- Enumeration date
- Mar 23, 2007
- Certification date
- May 16, 2025
- Last updated
- May 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – |
Other names
- Hazelden Plymouth (Doing Business As)
Practice location
11505 36th Ave NPlymouth, MN 55441-2304
Phone 800-257-7800
Mailing address
15251 Pleasant Valley RdCenter City, MN 55012-9640
Phone 800-257-7800
Authorized official
Ashley Gibson
Vp Payer Relations
6512134519
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