| Residential Transitions Incorporated | |
|
750 S Plaza Dr Ste 100 Mendota Heights MN 55120-1505 | |
| (651) 457-1461 | |
| (651) 455-1385 |
| Full Name | Residential Transitions Incorporated |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 750 S Plaza Dr Ste 100, Mendota Heights, Minnesota |
| Authorized Official Name and Position | Stephen Anthony Delong (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6514546118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Transitions Incorporated 750 S Plaza Dr Ste 100 Mendota Heights MN 55120-1505 Ph: (651) 457-1461 | Residential Transitions Incorporated 750 S Plaza Dr Ste 100 Mendota Heights MN 55120-1505 Ph: (651) 457-1461 |
| NPI Number | 1144725623 |
|---|---|
| Provider Enumeration Date | 03/27/2018 |
| Last Update Date | 10/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144725623 | NPI | - | NPPES |
| 1114420783 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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