NPIMap

Organization Active NPI

Professional Resource Network, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
National Provider Identifier
1861817207
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1067063-1-CDT Issued in MN
Legal business name
PROFESSIONAL RESOURCE NETWORK, INC
Practice address
1 Water St W
Suite 288
Saint Paul, MN 55107-2002
Phone
(651) 414-0063
Fax
(651) 788-7508
NPI assigned
Feb 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charie L Devolites, RN, BSN, MSHCA
Title
President/Ceo
Phone
(952) 858-8807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1067063-1-CDT MN Primary

Addresses

Primary practice location

1 Water St W
Suite 288
Saint Paul, MN 55107-2002

Mailing address

2740 American Blvd W
Suite 100
Bloomington, MN 55431-1203
Phone (952) 858-8807

Other names 1

  • Professional Resource Network Behavioral Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Professional Resource Network Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Water St W
Ste 288
Saint Paul, MN 55107
Phone (651) 414-0063

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1861817207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 AMERICAN BLVD W",
            "address_2": "SUITE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311203",
            "telephone_number": "952-858-8807",
            "fax_number": "952-858-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WATER ST W",
            "address_2": "SUITE 288",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072002",
            "telephone_number": "651-414-0063",
            "fax_number": "651-788-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL RESOURCE NETWORK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "DEVOLITES",
        "authorized_official_first_name": "CHARIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "952-858-8807",
        "authorized_official_credential": "RN, BSN, MSHCA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "1067063-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Resource Network Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.