Healthcare Provider Details

I. General information

NPI: 1245375120
Provider Name (Legal Business Name): COMMUNITY ACTION PARTNERSHIP OF RAMSEY & WASHINGTON COUNTIES (CAPRW)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SYNDICATE ST N SUITE 30
ST. PAUL MN
55104-4107
US

IV. Provider business mailing address

450 SYNDICATE ST N SUITE 30
ST. PAUL MN
55104-4107
US

V. Phone/Fax

Practice location:
  • Phone: 651-603-5823
  • Fax: 651-603-5990
Mailing address:
  • Phone: 651-603-5939
  • Fax: 651-603-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR 157956-9
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16108
License Number StateMN

VIII. Authorized Official

Name: CLARENCE HIGHTOWER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 651-603-5951