| Organization Name: | HAZELDEN CHASKA |
| NPI Number: | 1104194208 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK SHEETS (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1107 Hazeltine Blvd Suite 300, Md 67 Chaska |
| State: | MN US |
| Postal Code: | 553181009 |
| Phone Number: | 6512134286 |
| Fax Number: | |
| NPI Enumeration Date: | 12/05/2011 |
| NPI Last Update Date: | 12/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |