Provider Demographics
NPI:1932883741
Name:AMETHYST RECOVERY SOLUTIONS INC
Entity Type:Organization
Organization Name:AMETHYST RECOVERY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAREIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-269-6544
Mailing Address - Street 1:5862 BURKE TRL
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1583
Mailing Address - Country:US
Mailing Address - Phone:612-269-6544
Mailing Address - Fax:
Practice Address - Street 1:533 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2218
Practice Address - Country:US
Practice Address - Phone:651-494-4446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty