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Organization

GENERATIONS COMMUNITY SUPPORT SERVICE

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 E MARIE ST, #117, W ST PAUL, MN 55118
(612) 676-1604
(651) 552-9874
Mailing address
2649 PARK AVE, MINNEAPOLIS, MN 55407
(612) 676-1604
(612) 379-8235

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
05/04/2006
Last updated
08/22/2020
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