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Organization

RESIDENTIAL ADVANTAGES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization

Contact information

Practice address
1708 N GARDEN ST, NEW ULM, MN 56073-1556
(507) 359-7317
(507) 354-7274
Mailing address
220 MILWAUKEE ST STE 2, LAKEFIELD, MN 56150-9495
(507) 662-5236
(507) 662-5235

Taxonomy

Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
801708-1-RS
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
940745600
MN
Enumeration date
12/27/2006
Last updated
03/05/2023
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