Provider Demographics
NPI:1225318637
Name:TRUE FOUNDATION,LLC
Entity Type:Organization
Organization Name:TRUE FOUNDATION,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HURSE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LADC,CAC,SAP
Authorized Official - Phone:612-203-9809
Mailing Address - Street 1:8557 WYOMING AVE N STE 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-1847
Mailing Address - Country:US
Mailing Address - Phone:612-203-9809
Mailing Address - Fax:763-862-7005
Practice Address - Street 1:8557 WYOMING AVE N STE 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-1847
Practice Address - Country:US
Practice Address - Phone:612-203-9809
Practice Address - Fax:763-862-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1044690-2CDT101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty