Organization
HIS HOUSE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA A BRANNON (EXECUTIVE DIRECTOR)
(612) 325-4693
Entity
Organization
Contact information
Practice address
1866 WOODSTONE DR, VICTORIA, MN 55386-9634
(612) 325-4693
Mailing address
1866 WOODSTONE DR, VICTORIA, MN 55386-9634
(612) 325-4693
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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