Organization
AMHERST H. WILDER FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON ELIZABETH FORNEY (BUSINESS MANAGER - ESAS)
(651) 280-2357
Entity
Organization
Contact information
Practice address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2357
Mailing address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2357
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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