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General NPI Number Information
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NPI Number | 1235216151
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Entity Type | Organization
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Legal Business Name | HELENA FAMILY SUPPORT
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5301 E RIVER RD STE 110
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City | FRIDLEY
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State | MN
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Zip | 55421-3778
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Country | US
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Telephone | 763-432-3926
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Fax | 763-432-3926
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Provider Business Mailing Address
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Address Line | 13537 WINDYHILL RD
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City | MINNETONKA
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State | MN
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Zip | 55305-1011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JANE SHARKEY
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Credential | LMFT
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Telephone | 952-484-4885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1111
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License Number State | MN
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