Provider Demographics
NPI:1659819308
Name:TRU HEALTHCARE, INC.
Entity type:Organization
Organization Name:TRU HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-789-8769
Mailing Address - Street 1:2586 7TH AVE E
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3083
Mailing Address - Country:US
Mailing Address - Phone:651-633-7300
Mailing Address - Fax:651-633-7301
Practice Address - Street 1:3900 NORTHWOODS DR STE 240
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-6991
Practice Address - Country:US
Practice Address - Phone:651-633-7300
Practice Address - Fax:651-633-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty