Provider Demographics
NPI:1093769572
Name:VOLUNTEERS OF AMERICA MN/WI
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA MN/WI
Other - Org Name:VONA CENTER FOR MENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FJELSTUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-225-4000
Mailing Address - Street 1:9220 BASS LAKE RD STE 255
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3019
Mailing Address - Country:US
Mailing Address - Phone:763-252-4052
Mailing Address - Fax:888-965-5130
Practice Address - Street 1:9220 BASS LAKE RD STE 255
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-3019
Practice Address - Country:US
Practice Address - Phone:763-225-4052
Practice Address - Fax:888-965-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN694319501Medicaid
MN694319501Medicaid