Provider Demographics
NPI:1437208808
Name:RELIABLE HUMAN SERVICES, INC.
Entity Type:Organization
Organization Name:RELIABLE HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:KANMUE
Authorized Official - Last Name:KOLLEH
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:763-442-5136
Mailing Address - Street 1:5701 SHINGLE CREEK PKWY STE 470
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2519
Mailing Address - Country:US
Mailing Address - Phone:763-442-5136
Mailing Address - Fax:763-316-6852
Practice Address - Street 1:5701 SHINGLE CREEK PKWY STE 470
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2519
Practice Address - Country:US
Practice Address - Phone:763-442-5136
Practice Address - Fax:763-316-6852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN747912000302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN747912000Medicaid