Provider Demographics
NPI:1497078257
Name:VOLUTEERS OF AMERICA BAR-NONE
Entity Type:Organization
Organization Name:VOLUTEERS OF AMERICA BAR-NONE
Other - Org Name:BAR-NONE - SUNRISE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-753-2500
Mailing Address - Street 1:22426 SAINT FRANCIS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-9670
Mailing Address - Country:US
Mailing Address - Phone:763-753-2500
Mailing Address - Fax:763-753-5999
Practice Address - Street 1:22426 SAINT FRANCIS BLVD
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-9670
Practice Address - Country:US
Practice Address - Phone:763-753-2500
Practice Address - Fax:763-753-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1036848-8-CRF322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA352658000OtherUMPI