24D2005019 CLIA NUMBER - ANNA WESTIN HOUSE FIRST FLOOR

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Laboratory Demographics

CLIA Number: 24D2005019

Facility Name: ANNA WESTIN HOUSE FIRST FLOOR

Facility Address:
1449 CLEVELAND AVENUE N
SAINT PAUL, MN
ZIP 55108
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Facility Phone Number: 651 645-5323

Facility Type: Other - RESIDENTAIL TREATMENT FAC

Certificate Type: Waiver

NPI Number: 1649309246

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	24D2005019
LAB Type	Other - RESIDENTAIL TREATMENT FAC
Facility Name	ANNA WESTIN HOUSE FIRST FLOOR
Street	1449 CLEVELAND AVENUE N
City	SAINT PAUL
State	MN
ZIP	55108
Phone	651 645-5323
CertificateType	4
CertificateEffectiveDate	3/18/2024
CertificateExpirationDate	3/17/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024