Organization
ABC MENTAL HEALTH THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAINE QIAO JORENTO LICSW (EXECUTIVE DIRECTOR)
(651) 815-5145
Entity
Organization
Contact information
Practice address
1845 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3401
(651) 644-2600
(651) 644-2888
Mailing address
1845 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3401
(651) 644-2600
(651) 644-2888
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
CERTIFIED DAY TX
MN
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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