1417489212 NPI number — BASIC NEEDS

Table of content: (NPI 1417489212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417489212 NPI number — BASIC NEEDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BASIC NEEDS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE NATIONAL FAMILY COUNCIL
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417489212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3333 N 4TH ST STE 25
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55412-2615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-767-8671
Provider Business Mailing Address Fax Number:
612-827-1215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 N 4TH ST STE 25
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55412-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-767-8671
Provider Business Practice Location Address Fax Number:
612-827-1215
Provider Enumeration Date:
03/30/2017

Additional Information

Authorized Official

Authorized Official Last Name:
CARPENTER
Authorized Official First Name:
CHERLEIGH
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
612-998-6300

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X , with the licence number:  1009291 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com