Basic Information
Provider Information
NPI: 1558455501
EntityType: 2
ReplacementNPI:  
OrganizationName: TOUCHSTONE MENTAL HEALTH
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 2312 SNELLING AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554043157
CountryCode: US
TelephoneNumber: 6128746409
FaxNumber: 6128740157
Practice Location
Address1: 2312 SNELLING AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554043157
CountryCode: US
TelephoneNumber: 6128746409
FaxNumber: 6128740157
Other Information
ProviderEnumerationDate: 10/03/2006
LastUpdateDate: 05/26/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HEROLD
AuthorizedOfficialFirstName: DARVIA
AuthorizedOfficialMiddleName: K
AuthorizedOfficialTitleorPosition: CFO/VP OF FINANCE & ADMINISTRATION
AuthorizedOfficialTelephone: 6127672162
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251B00000X07175MNY AgenciesCase Management 

No ID Information.


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