MEDICARE: RAMSEY COUNTY MENTAL HEALTH CENTER

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
1	314000000X	Skilled Nursing Facility	327792	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7122699	OTHER	MN	MEDICA
2	8648RA	OTHER	MN	BLUE CROSS BLUE SHIELD
3	000002877	OTHER	MN	HEALTH PARTNERS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	NH0086	OTHER	MN	UCARE

General Provider Information

NPI Number	:	1699760785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAMSEY COUNTY MENTAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	2000 WHITE BEAR AVE N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55109-3713
Country	:	US
Telephone Number	:	651-777-7486
Fax Number	:	651-777-1426

Provider Business Practice Location Address
First Line	:	2000 WHITE BEAR AVE N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55109-3713
Country	:	US
Telephone Number	:	651-777-7486
Fax Number	:	651-777-1426

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PATRICIA J RELLER
Credential	:	CNHA
Telephone Number	:	651-251-2416

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	12/23/2008

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