Provider Demographics
NPI:1790909703
Name:MENTAL HEALTH RESOURCES, INC.
Entity type:Organization
Organization Name:MENTAL HEALTH RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-659-2900
Mailing Address - Street 1:762 TRANSFER RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1404
Mailing Address - Country:US
Mailing Address - Phone:651-659-2900
Mailing Address - Fax:651-645-7307
Practice Address - Street 1:762 TRANSFER RD
Practice Address - Street 2:SUITE 21
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114
Practice Address - Country:US
Practice Address - Phone:651-659-2900
Practice Address - Fax:651-645-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN395253300Medicaid