Healthcare Provider Details

I. General information

NPI: 1356507479
Provider Name (Legal Business Name): JEWISH FAMILY & CHILDREN'S SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 5TH ST SE #328
MINNEAPOLIS MN
55414-4504
US

IV. Provider business mailing address

5905 GOLDEN VALLEY RD
GOLDEN VALLEY MN
55422-4463
US

V. Phone/Fax

Practice location:
  • Phone: 612-623-3363
  • Fax: 612-331-9401
Mailing address:
  • Phone: 952-546-0616
  • Fax: 952-593-1778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number500958001
License Number StateMN

VIII. Authorized Official

Name: DANIEL BELICH
Title or Position: CFO
Credential:
Phone: 952-546-0616