Provider Demographics
NPI:1548551823
Name:MERIDIAN BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:MERIDIAN BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUVAGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-326-7562
Mailing Address - Street 1:550 MAIN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-3274
Mailing Address - Country:US
Mailing Address - Phone:612-326-7556
Mailing Address - Fax:
Practice Address - Street 1:3329 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-454-2260
Practice Address - Fax:612-454-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302929101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty