Healthcare Provider Details

I. General information

NPI: 1659819308
Provider Name (Legal Business Name): TRU HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 NORTHWOODS DR STE 240
ARDEN HILLS MN
55112-6991
US

IV. Provider business mailing address

2586 7TH AVE E SUITE 302
NORTH ST PAUL MN
55109-3083
US

V. Phone/Fax

Practice location:
  • Phone: 651-633-7300
  • Fax: 651-633-7301
Mailing address:
  • Phone: 651-633-7300
  • Fax: 651-633-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY C LIVELY
Title or Position: CEO
Credential:
Phone: 651-789-8769