Healthcare Provider Details

I. General information

NPI: 1184262271
Provider Name (Legal Business Name): EPIPHANY FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W BROADWAY AVE
MINNEAPOLIS MN
55411-2532
US

IV. Provider business mailing address

1201 W BROADWAY AVE
MINNEAPOLIS MN
55411-2532
US

V. Phone/Fax

Practice location:
  • Phone: 612-616-2974
  • Fax:
Mailing address:
  • Phone: 612-616-2974
  • Fax: 612-979-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREA QUEEN LANGFORD
Title or Position: OWNER
Credential: LMFT
Phone: 612-616-2974