Healthcare Provider Details
I. General information
NPI: 1871466623
Provider Name (Legal Business Name): CTIONS & PROVIDERS HOUSING MGMT, PROFESSIONAL AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1251 WASHINGTON AVE N # 1521
MINNEAPOLIS MN
55401-1036
US
IV. Provider business mailing address
1251 WASHINGTON AVE N # 1521
MINNEAPOLIS MN
55401-1036
US
V. Phone/Fax
- Phone: 612-401-7329
- Fax: 763-218-7439
- Phone: 612-401-7329
- Fax: 763-218-7439
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101200000X |
| Taxonomy | Drama Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251300000X |
| Taxonomy | Local Education Agency (LEA) |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
A
DA'RON
PHILLIPS
SR.
Title or Position: PRESIDENT OWNER
Credential:
Phone: 612-401-7329