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General NPI Number Information
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NPI Number | 1811228133
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Entity Type | Organization
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Legal Business Name | FAMILY CONNECTIONS COUNSELING CENTER LLC
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 11608 WAYZATA BLVD
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City | MINNETONKA
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State | MN
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Zip | 55305-2009
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Country | US
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Telephone | 952-544-0964
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Fax | 952-544-6405
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Provider Business Mailing Address
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Address Line | 11608 WAYZATA BLVD
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City | MINNETONKA
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State | MN
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Zip | 55305-2009
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Country | US
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Telephone | 952-544-0964
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Fax | 952-544-6405
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOYCE MARIE ARENDT
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Credential | LISCW
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Telephone | 612-716-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 15568
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License Number State | MN
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