Organization · Type 2 NPI

Theodore I

Mental Illness Community Based Residential Treatment Facility · St. Paul, MN

NPI number 1831254408 Active

Practice location

1314 Livingston Ave
St. Paul, MN 55118-2409

Call (651) 501-2378 Map

Fax (651) 738-1737

Mailing address

1865 Old Hudson Rd
St. Paul, MN 55119-4308

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000X802493-1-RMI (MN)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1831254408

Theodore I's National Provider Identifier is 1831254408, issued on Dec 26, 2006. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in St. Paul, MN. The record was last updated on Aug 22, 2020.