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General NPI Number Information
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NPI Number | 1275062408
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Entity Type | Organization
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Legal Business Name | THE HEALING HOUSE OF SAINT PAUL
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Dates
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Enumeration Date | 06/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 338 SNELLING AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55105-2048
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Country | US
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Telephone | 612-269-9635
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Fax |
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Provider Business Mailing Address
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Address Line | 338 SNELLING AVE S
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City | SAINT PAUL
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State | MN
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Zip | 55105-2048
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Country | US
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Telephone | 612-269-9635
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SHAWN DAVID SCHWARTZ
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Credential |
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Telephone | 651-592-8294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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