Healthcare Provider Details

I. General information

NPI: 1699760785
Provider Name (Legal Business Name): RAMSEY COUNTY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WHITE BEAR AVE N
SAINT PAUL MN
55109-3713
US

IV. Provider business mailing address

2000 WHITE BEAR AVE N
SAINT PAUL MN
55109-3713
US

V. Phone/Fax

Practice location:
  • Phone: 651-777-7486
  • Fax: 651-777-1426
Mailing address:
  • Phone: 651-777-7486
  • Fax: 651-777-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number327792
License Number StateMN

VIII. Authorized Official

Name: MRS. PATRICIA J RELLER
Title or Position: ADMINISTRATOR
Credential: CNHA
Phone: 651-251-2416