Provider Demographics
NPI:1417021429
Name:SOUTH METRO HUMAN SERVICES
Entity Type:Organization
Organization Name:SOUTH METRO HUMAN SERVICES
Other - Org Name:TARGETED CASE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-256-1233
Mailing Address - Street 1:400 SIBLEY ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1941
Mailing Address - Country:US
Mailing Address - Phone:651-291-1979
Mailing Address - Fax:651-291-7378
Practice Address - Street 1:400 SIBLEY ST
Practice Address - Street 2:SUITE 500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1941
Practice Address - Country:US
Practice Address - Phone:651-291-1979
Practice Address - Fax:651-291-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management