Provider Demographics
NPI:1760549851
Name:RAMSEY COUNTY MENTAL HEALTH CRISIS PROGRAM
Entity Type:Organization
Organization Name:RAMSEY COUNTY MENTAL HEALTH CRISIS PROGRAM
Other - Org Name:CATHOLIC CHARITIES COUNSELING DIVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-285-2188
Mailing Address - Street 1:215 OLD SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-215-2268
Mailing Address - Fax:651-222-4581
Practice Address - Street 1:215 OLD SIXTH STREET
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102
Practice Address - Country:US
Practice Address - Phone:651-215-2268
Practice Address - Fax:651-222-4581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10413251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========Medicaid