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NPI Code Detail

MEDICARE: SPECIALIZED TREATMENT SERVICES, INC.

MEDICARE: SPECIALIZED TREATMENT SERVICES, INC.
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
1261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1679858039
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECIALIZED TREATMENT SERVICES, INC.
Provider Business Mailing Address
First Line : 1132 CENTRAL AVE NE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1512
Country : US
Telephone Number : 612-236-1700
Fax Number : 612-236-1701
Provider Business Practice Location Address
First Line : 1132 CENTRAL AVE NE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1512
Country : US
Telephone Number : 612-236-1700
Fax Number : 612-236-1701
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : CARRIE MCGREGOR
Credential :
Telephone Number : 612-236-1702
Provider Enumeration Date : 10/18/2011
Last Update Date : 10/18/2011

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Directions to “SPECIALIZED TREATMENT SERVICES, INC. ” Practice Location

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