Provider Demographics
NPI:1417768771
Name:TRANSFORMATION HOUSE INC
Entity type:Organization
Organization Name:TRANSFORMATION HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-452-7011
Mailing Address - Street 1:1410 S FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2164
Mailing Address - Country:US
Mailing Address - Phone:763-427-7155
Mailing Address - Fax:763-427-6084
Practice Address - Street 1:1410 S FERRY RD
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2164
Practice Address - Country:US
Practice Address - Phone:763-427-7155
Practice Address - Fax:763-427-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty