Provider Demographics
NPI:1699512061
Name:ROSEWOOD FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:ROSEWOOD FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMFT
Authorized Official - Prefix:
Authorized Official - First Name:NORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KNABE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:651-666-7624
Mailing Address - Street 1:5832 RED PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-2393
Mailing Address - Country:US
Mailing Address - Phone:651-666-7624
Mailing Address - Fax:651-389-9444
Practice Address - Street 1:5832 RED PINE BLVD
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-2393
Practice Address - Country:US
Practice Address - Phone:612-245-9237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty