Provider Demographics
NPI:1174781777
Name:SAFE TRANSITIONS
Entity type:Organization
Organization Name:SAFE TRANSITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGENHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-389-3291
Mailing Address - Street 1:3656 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BARNUM
Mailing Address - State:MN
Mailing Address - Zip Code:55707-9651
Mailing Address - Country:US
Mailing Address - Phone:218-389-3291
Mailing Address - Fax:218-389-9851
Practice Address - Street 1:3656 FRONT ST
Practice Address - Street 2:
Practice Address - City:BARNUM
Practice Address - State:MN
Practice Address - Zip Code:55707-9651
Practice Address - Country:US
Practice Address - Phone:218-389-3291
Practice Address - Fax:218-389-9851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA133110000Medicaid
MNA692467000Medicaid
MNA749460200Medicaid
MNA839497100Medicaid
MNA103667100Medicaid
MNA752922100Medicaid
MNA878478000Medicaid
MNA507612000Medicaid
MNA204663000Medicaid
MNA270437000Medicaid
MNA603952000Medicaid
MNA493493000Medicaid