| My Home Inc | |
|
1010 University Ave W Suite 1 Saint Paul MN 55104-4746 | |
| (651) 659-0359 | |
| (651) 645-1688 |
| Full Name | My Home Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1010 University Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Farris L. Glover (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516590359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Home Inc 1010 University Ave W Suite 1 Saint Paul MN 55104-4746 Ph: (651) 659-0359 | My Home Inc 1010 University Ave W Suite 1 Saint Paul MN 55104-4746 Ph: (651) 659-0359 |
| NPI Number | 1649377706 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649377706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1038424-1-CDT (Minnesota) | Primary |
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