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General NPI Number Information
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NPI Number | 1437634730
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Entity Type | Organization
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Legal Business Name | HAZELDEN BETTY FORD FOUNDATION
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 1231 116TH AVE. NE SUITE 410
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City | BELLEVUE
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State | WA
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Zip | 98004
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Country | US
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Telephone | 800-257-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 15251 PLEASANT VALLEY RD
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City | CENTER CITY
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State | MN
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Zip | 55012-9640
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Country | US
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Telephone | 800-257-7800
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Fax |
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Authorized Official
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Title or Position | VP PAYER RELATIONS
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Name | ASHLEY GIBSON
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Credential |
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Telephone | 651-213-4519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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