Provider Demographics
NPI:1104408509
Name:BUICE BEHAVIORAL HEALTHCARE CONSULTANTS INC
Entity type:Organization
Organization Name:BUICE BEHAVIORAL HEALTHCARE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RENAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUICE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:763-807-5254
Mailing Address - Street 1:910 SHERIDAN AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3615
Mailing Address - Country:US
Mailing Address - Phone:763-807-5254
Mailing Address - Fax:612-465-3032
Practice Address - Street 1:1710 DOUGLAS DR N STE 120
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4352
Practice Address - Country:US
Practice Address - Phone:763-807-5254
Practice Address - Fax:763-465-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health