Provider Demographics
NPI:1437298668
Name:KINDRED FAMILY FOCUS
Entity Type:Organization
Organization Name:KINDRED FAMILY FOCUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-350-9236
Mailing Address - Street 1:2800 UNIVERSITY AVE SE STE 204
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-4205
Mailing Address - Country:US
Mailing Address - Phone:218-671-1127
Mailing Address - Fax:612-331-3520
Practice Address - Street 1:5985 RICE CREEK PKWY STE 202
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-5037
Practice Address - Country:US
Practice Address - Phone:612-331-4429
Practice Address - Fax:612-331-3520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN801978-7-CPA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health