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General NPI Number Information
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NPI Number | 1346314465
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Entity Type | Organization
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Legal Business Name | SOUTH METRO HUMAN SERVICES- TCM
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 166 4TH ST E
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City | SAINT PAUL
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State | MN
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Zip | 55101-1421
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Country | US
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Telephone | 651-291-1979
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Fax | 651-291-7378
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Provider Business Mailing Address
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Address Line | 166 4TH ST E
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City | ST PAUL
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State | MN
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Zip | 55101
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Country | US
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Telephone | 651-291-1979
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Fax | 651-291-7378
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOM PAUL
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Credential |
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Telephone | 651-256-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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