Provider Demographics
NPI:1689197782
Name:RIGHT RESPONSE LLC
Entity Type:Organization
Organization Name:RIGHT RESPONSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-306-4575
Mailing Address - Street 1:5108 LAKESIDE AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3734
Mailing Address - Country:US
Mailing Address - Phone:1612-306-4575
Mailing Address - Fax:
Practice Address - Street 1:225 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1201
Practice Address - Country:US
Practice Address - Phone:612-306-4575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)