Provider Demographics
NPI:1023530797
Name:STABLE HOUSING SOLUTIONS OF MN LLC
Entity type:Organization
Organization Name:STABLE HOUSING SOLUTIONS OF MN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:PATRITIA
Authorized Official - Last Name:BREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-438-5701
Mailing Address - Street 1:6575 141ST AVE. NW SUITE 100
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303
Mailing Address - Country:US
Mailing Address - Phone:763-438-5701
Mailing Address - Fax:
Practice Address - Street 1:6575 141ST AVE. NW SUITE 100
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303
Practice Address - Country:US
Practice Address - Phone:763-438-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1087196-1-HCBS253J00000X
320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No253J00000XAgenciesFoster Care Agency