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NPI Code Detail

MEDICARE: HAZELDEN BETTY FORD FOUNDATION

MEDICARE: HAZELDEN BETTY FORD FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1386972719
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAZELDEN BETTY FORD FOUNDATION
Provider Business Mailing Address
First Line : 15251 PLEASANT VALLEY RD
Second Line :
City : CENTER CITY
State : MN
Zip : 55012-9640
Country : US
Telephone Number : 800-257-7800
Fax Number :
Provider Business Practice Location Address
First Line : 950 6TH AVE N
Second Line :
City : NAPLES
State : FL
Zip : 34102-5633
Country : US
Telephone Number : 800-257-7800
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MARC BAER
Credential :
Telephone Number : 800-257-7800
Provider Enumeration Date : 11/23/2009
Last Update Date : 12/02/2025

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Directions to “HAZELDEN BETTY FORD FOUNDATION ” Practice Location

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