Organization
SOUTH METRO HUMAN SERVICES
Active
Other names
Community Foundations
Organization subpart
No
Provider details
NPI number
Authorized official
TOM PAUL (PRESIDENT)
(651) 256-1234
Entity
Organization
Contact information
Practice address
1096 GERVAIS AVE, MAPLEWOOD, MN 55109-1909
(651) 221-9880
(651) 225-1545
Mailing address
1096 GERVIS AVE, MAPLEWOOD, MN 55109
(651) 221-9880
(651) 225-1545
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
801654-1-RMI
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355499600
—
MN
Enumeration date
10/11/2006
Last updated
05/21/2015
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