Provider Demographics
NPI:1093503823
Name:SOUTH METRO HUMAN SERVICES
Entity type:Organization
Organization Name:SOUTH METRO HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-802-9820
Mailing Address - Street 1:166 4TH ST E STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1667
Mailing Address - Country:US
Mailing Address - Phone:651-291-1979
Mailing Address - Fax:
Practice Address - Street 1:166 4TH ST E STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1667
Practice Address - Country:US
Practice Address - Phone:651-291-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH METRO HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251B00000XAgenciesCase Management