Provider Demographics
NPI:1174670111
Name:COMMUNITY INVOLVEMENT PROGRAMS
Entity Type:Organization
Organization Name:COMMUNITY INVOLVEMENT PROGRAMS
Other - Org Name:ARMHS PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:TWILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-362-4400
Mailing Address - Street 1:1600 BROADWAY STREET NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2617
Mailing Address - Country:US
Mailing Address - Phone:612-362-4400
Mailing Address - Fax:612-547-0556
Practice Address - Street 1:1600 BROADWAY STREET NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2617
Practice Address - Country:US
Practice Address - Phone:612-362-4400
Practice Address - Fax:612-547-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN667658800Medicaid