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General NPI Number Information
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NPI Number | 1275634230
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Entity Type | Organization
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Legal Business Name | FAMILYWISE SERVICES
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 3036 UNIVERSITY AVE SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-3316
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Country | US
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Telephone | 612-617-0191
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Fax | 612-617-0193
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Provider Business Mailing Address
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Address Line | 3036 UNIVERSITY AVE SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-3316
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Country | US
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Telephone | 612-617-0191
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Fax | 612-617-0193
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANN GAASCH
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Credential |
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Telephone | 612-877-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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