Healthcare Provider Details

I. General information

NPI: 1932261377
Provider Name (Legal Business Name): POWER OF RELATIONSHIPS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 LILAC DR N SUITE 130
GOLDEN VALLEY MN
55422-4700
US

IV. Provider business mailing address

14329 ALLEN DR
SAVAGE MN
55378-2230
US

V. Phone/Fax

Practice location:
  • Phone: 612-874-6746
  • Fax: 612-874-6745
Mailing address:
  • Phone: 612-221-2441
  • Fax: 612-874-6745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberLP3544
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLP3544
License Number StateMN

VIII. Authorized Official

Name: MR. JAMES W KEENAN
Title or Position: PRESIDENT, EXECUTIVE DIRECTOR
Credential: MS, LP
Phone: 612-221-2441