Organization
COMMUNITY INVOLVEMENT PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN EVERETT (EXECUTIVE DIRECTOR)
(612) 362-4413
Entity
Organization
Contact information
Practice address
1600 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2617
(612) 362-4444
(612) 362-4479
Mailing address
1600 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2617
(612) 362-4444
(612) 362-4479
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15119
MN
Other
Enumeration date
08/18/2008
Last updated
07/28/2010
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