Provider Demographics
NPI:1386016822
Name:TRU HEALTHCARE, INC.
Entity Type:Organization
Organization Name:TRU HEALTHCARE, INC.
Other - Org Name:TRU HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-789-8769
Mailing Address - Street 1:2586 7TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3083
Mailing Address - Country:US
Mailing Address - Phone:651-633-7300
Mailing Address - Fax:651-633-7301
Practice Address - Street 1:14525 HIGHWAY 7 STE 250
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3734
Practice Address - Country:US
Practice Address - Phone:651-633-7300
Practice Address - Fax:651-633-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083A0300X, 251G00000X, 251S00000X
MN370453251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction MedicineGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty