MEDICARE: RAMSEY COUNTY HUMAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	2351	MN

General Provider Information

NPI Number	:	1700279924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAMSEY COUNTY HUMAN SERVICES

Provider Business Mailing Address
First Line	:	2100 WILSON AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-4146
Country	:	US
Telephone Number	:	651-771-1301
Fax Number	:	651-771-2542

Provider Business Practice Location Address
First Line	:	2100 WILSON AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-4146
Country	:	US
Telephone Number	:	651-771-1301
Fax Number	:	651-771-2542

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	CAROLYN LARSON
Credential	:	LMFT
Telephone Number	:	651-771-1301

Provider Enumeration Date	:	03/12/2015
Last Update Date	:	03/12/2015

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