Organization
VINE FAITH IN ACTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA KOPISCHKE (FISCAL MANAGER)
(507) 386-5572
Entity
Organization
Contact information
Practice address
421 E HICKORY ST, MANKATO, MN 56001-2635
(507) 387-1666
(507) 387-5775
Mailing address
421 E HICKORY ST, MANKATO, MN 56001-2635
(507) 387-1666
(507) 387-5775
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
347C00000X
Private Vehicle
—
—
372500000X
Chore Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A617642900
UMPI
MN
Enumeration date
09/23/2019
Last updated
12/18/2019
Update your record
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