OUR HOUSE OF MINNESOTA, INC. is an intermediate care facility mentally retarded in Saint Paul, MN. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. OUR HOUSE OF MINNESOTA, INC. NPI is 1568563898. The provider is registered as an organization entity type.
The provider's business location address is:
1846 PORTLAND AVE
SAINT PAUL, MN
ZIP 55104-062
Phone: (651) 646-1104
Fax: (651) 646-1104
The provider's authorized official is Dennis Holman .
The authorized official title is Administrator and has the following contact phone number (651) 646-1104.
The CLIA number assigned to this NPI record is 24D1034621 - intermediate care facility/individuals with intellectual disability with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 9/26/2006 and was last updated on 8/22/2020.