Healthcare Provider Details
I. General information
NPI: 1891972303
Provider Name (Legal Business Name): MINNEAPOLIS AMERICAN INDIAN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2008
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1530 E FRANKLIN AVE
MINNEAPOLIS MN
55404-2136
US
IV. Provider business mailing address
1530 E FRANKLIN AVE
MINNEAPOLIS MN
55404-2136
US
V. Phone/Fax
- Phone: 612-879-1700
- Fax:
- Phone: 612-879-1700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
FRANCES
FAIRBANKS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 612-879-1704