Provider Demographics
NPI:1053486902
Name:RELATE INC
Entity type:Organization
Organization Name:RELATE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TWITON
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:952-230-3958
Mailing Address - Street 1:5125 COUNTY ROAD 101,
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345
Mailing Address - Country:US
Mailing Address - Phone:952-932-7277
Mailing Address - Fax:952-932-9827
Practice Address - Street 1:5125 COUNTY ROAD 101 STE 300
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4157
Practice Address - Country:US
Practice Address - Phone:952-230-3958
Practice Address - Fax:952-932-9827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8020651MHC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN800022100Medicaid
MN1053486902Medicaid