Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Medical Addiction Treatment Clinic

Organization Addiction Medicine (Internal Medicine) Physician · NPI 1891031209

Medical Addiction Treatment Clinic is an Addiction Medicine (Internal Medicine) Physician in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
Specialties on file
4
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Practice location Address checks out

3805 Washington Ave N
Minneapolis, MN 55412-2141
Phone: (612) 887-6282
Fax: (612) 437-4992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Internal Medicine) Physician (primary) Taxonomy 207RA0401X · Licence 52519 (MN)
Clinic/Center Taxonomy 261Q00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence 12684 (MN)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1891031209
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anne Pylkas — Ceo · (612) 435-7380
Other names Sage Prairie
NPI enumeratedDecember 13, 2012
Last updated in NPPESAugust 17, 2022
Certification dateAugust 17, 2022
Mailing address3805 Washington Ave N, Minneapolis, MN 55412-2141

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