Healthcare Provider Details

I. General information

NPI: 1902398860
Provider Name (Legal Business Name): MENTAL HEALTH RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 TRANSFER RD STE 21
SAINT PAUL MN
55114-1489
US

IV. Provider business mailing address

762 TRANSFER RD STE 21
SAINT PAUL MN
55114-1489
US

V. Phone/Fax

Practice location:
  • Phone: 651-659-2900
  • Fax:
Mailing address:
  • Phone: 651-659-2914
  • Fax: 651-645-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberPENDING
License Number StateMN

VIII. Authorized Official

Name: ROXANNE CONDON
Title or Position: VP OF ADMINISTRATIVE SERVICES
Credential:
Phone: 651-659-2900