Organization
AFRICAN AMERICAN FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN G LOFGREN LADC (CHIEF OPERATIONS OFFICER)
(612) 238-2302
Entity
Organization
Contact information
Practice address
1041 SELBY AVE, SAINT PAUL, MN 55104-6535
(612) 871-7878
Mailing address
PO BOX 8900, MINNEAPOLIS, MN 55408-0900
(612) 871-7878
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
80113422CDT
MN
251S00000X
Community/Behavioral Health Agency
8059762CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010757300
MNDHS PROVIDER NUMBER
MN
01
—
707055100
MN DHS PROVIDER IHENNEPIN
MN
Enumeration date
03/13/2008
Last updated
05/13/2008
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