Provider Demographics
NPI:1598588527
Name:SOLAR BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:SOLAR BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-202-5326
Mailing Address - Street 1:682 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3520
Mailing Address - Country:US
Mailing Address - Phone:763-202-5326
Mailing Address - Fax:
Practice Address - Street 1:682 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3520
Practice Address - Country:US
Practice Address - Phone:612-234-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty