Organization
FAMILYWISE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN GAASCH (EXECUTIVE DIRECTOR)
(612) 877-7827
Entity
Organization
Contact information
Practice address
3036 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3316
(612) 617-0191
(612) 617-0193
Mailing address
3036 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3316
(612) 617-0191
(612) 617-0193
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060108001
METROPOLITAN HEALTH PLAN
MN
01
—
1983
UCARE MINNESOTA
MN
05
—
198428400
—
MN
01
—
835556800
MEDICAL ASSISTANCE
MN
Enumeration date
09/25/2006
Last updated
07/22/2022
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