Organization
RESIDENTIAL ADVANTAGES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
107 S BLUE MOUND AVE, LUVERNE, MN 56156-1924
(507) 283-4088
(507) 283-9448
Mailing address
6600 FRANCE AVE S, EDINA, MN 55435-1805
(952) 925-5067
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
801449-1RS
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299543300
—
MN
Enumeration date
12/27/2006
Last updated
03/05/2023
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