Organization
HOMEBASE HOUSING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN MENZEL (CEO)
(218) 831-8710
Entity
Organization
Contact information
Practice address
102 LAUREL ST STE 2, BRAINERD, MN 56401-3586
(218) 831-8710
Mailing address
102 LAUREL ST STE 2, BRAINERD, MN 56401-3586
(218) 831-8710
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A897932500
UMPI
MN
Enumeration date
07/30/2021
Last updated
05/31/2023
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