FAMILY REVELATIONS INC. NPI 1790212926

NPI Information

NPI: 1790212926
Provider Name: FAMILY REVELATIONS INC.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
1303 S FRONTAGE RD STE 275
HASTINGS, MN
ZIP 55033
Phone: (651) 319-6484
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FAMILY REVELATIONS INC. is an adult mental health clinic center in Hastings, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. FAMILY REVELATIONS INC. NPI is 1790212926. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1303 S FRONTAGE RD STE 275
HASTINGS, MN
ZIP 55033
Phone: (651) 319-6484
Fax: (651) 925-0442

The provider's authorized official is Bernie Jerome Menge .
The authorized official title is Owner / Partner and has the following contact phone number (651) 319-6484.

The enumeration date for this NPI number is 5/18/2017 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	3335	MISSOURI	No
2	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	3335	MINNESOTA	No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health		MINNESOTA	No
4	261QM0850X	Clinic/Center	Adult Mental Health	3335	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1134490469	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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