Provider Demographics
NPI:1023199676
Name:FAMILY VISIONS, INC.
Entity Type:Organization
Organization Name:FAMILY VISIONS, INC.
Other - Org Name:FAMILY VISIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS LP
Authorized Official - Phone:763-572-8187
Mailing Address - Street 1:7362 UNIVERSITY AVE NE STE 302
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3150
Mailing Address - Country:US
Mailing Address - Phone:763-572-8187
Mailing Address - Fax:
Practice Address - Street 1:7362 UNIVERSITY AVE NE STE 302
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3150
Practice Address - Country:US
Practice Address - Phone:763-572-8187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN102510OtherHEALTH PARTNERS
MN6263843OtherUBH
MN049L4FAOtherBCBS
MN141769OtherUCARE
MN030703004OtherMHP
MN111680100Medicaid