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General NPI Number Information
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NPI Number | 1891713681
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC RECOVERY PA
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2550 UNIVERSITY AVE W SUITE 229N
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City | SAINT PAUL
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State | MN
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Zip | 55114
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Country | US
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Telephone | 651-645-3115
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Fax | 651-645-2752
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W SUITE 229N
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City | SAINT PAUL
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State | MN
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Zip | 55114
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Country | US
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Telephone | 651-645-3115
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Fax | 651-645-2752
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMY JO CLUTE
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Credential |
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Telephone | 651-294-3436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1339
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1339
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License Number State | MN
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