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24D2278674 CLIA NUMBER - COMPASSIONATE QUALITY PSYCHIATRY

Laboratory Demographics

CLIA Number: 24D2278674

Facility Name: COMPASSIONATE QUALITY PSYCHIATRY

Facility Address:
4135 RICHARD AVENUE, SUITE 201
HERMANTOWN, MN
ZIP 55811
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Facility Phone Number: 612 429-1011

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1932852860

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 24D2278674
LAB Type Community Clinic
Facility Name COMPASSIONATE QUALITY PSYCHIATRY
Street 4135 RICHARD AVENUE, SUITE 201
City HERMANTOWN
State MN
ZIP 55811
Phone 612 429-1011
CertificateType 4
CertificateEffectiveDate 3/22/2023
CertificateExpirationDate 3/21/2025
FacilityType Waiver

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