Provider Demographics
NPI:1629545017
Name:RHSC INC.
Entity Type:Organization
Organization Name:RHSC INC.
Other - Org Name:AFTON PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-254-9350
Mailing Address - Street 1:525 PARK ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2197
Mailing Address - Country:US
Mailing Address - Phone:651-254-1821
Mailing Address - Fax:
Practice Address - Street 1:2715 UPPER AFTON RD E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55119-4774
Practice Address - Country:US
Practice Address - Phone:651-254-4736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RHSC INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-24
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1092326Medicaid