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Organization

GENERATIONS: COMMUNITY SUPPORT SERVICES

Active
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Organization

GENERATIONS: COMMUNITY SUPPORT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN JOAN GORMAN LICSW (PRESIDENT)
(612) 676-1604
Entity
Organization

Contact information

Practice address
60 MARIE AVE E, SAINT PAUL, MN 55118-5910
(651) 552-9071
(651) 552-9874
Mailing address
2649 PARK AVE S., MINNEAPOLIS, MN 55047
(612) 676-1604
(612) 379-8235

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1500
MN

Other

Enumeration date
09/28/2006
Last updated
04/03/2009
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