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General NPI Number Information
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NPI Number | 1659819308
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Entity Type | Organization
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Legal Business Name | TRU HEALTHCARE, INC.
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 3900 NORTHWOODS DR STE 240
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City | ARDEN HILLS
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State | MN
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Zip | 55112-6991
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Country | US
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Telephone | 651-633-7300
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Fax | 651-633-7301
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Provider Business Mailing Address
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Address Line | 2586 7TH AVE E SUITE 302
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City | NORTH ST PAUL
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State | MN
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Zip | 55109-3083
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Country | US
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Telephone | 651-633-7300
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Fax | 651-633-7301
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Authorized Official
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Title or Position | CEO
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Name | TIMOTHY C LIVELY
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Credential |
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Telephone | 651-789-8769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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