Theresas Home LLC
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · South Saint Paul, MN
NPI 1457022501 · NPPES record last updated Sep 27, 2021
Key facts
- NPI
- 1457022501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- THERESAS HOME LLC
- Practice address
- 224 2ND Ave S
South Saint Paul, MN 55075-2346 - Phone
- (763) 291-4288
- NPI assigned
- Sep 27, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Vivian Ngongang Ogunyemi, DNP
- Title
- Ceo
- Phone
- (763) 291-4288
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
224 2ND Ave S
South Saint Paul, MN 55075-2346
Mailing address
9985 Austin St NE
Circle Pines, MN 55014-2412
Phone (763) 291-4288
Other providers in South Saint Paul, MN
- Marty Michael Spanish
- SPPS LLC L L C
- Sun Medical Interpreting LLC
- Lisa Michele Suter
- Miranda Tapp
- Rebecca Rose Thompson
- Lynne Zimmerman
All providers in South Saint Paul, MN · Mental Illness Community Based Residential Treatment Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.