Provider Demographics
NPI:1518537901
Name:JOURNEY COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:JOURNEY COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAMAERA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:612-250-6726
Mailing Address - Street 1:3221 71ST ST E
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-2552
Mailing Address - Country:US
Mailing Address - Phone:612-250-6726
Mailing Address - Fax:
Practice Address - Street 1:3221 71ST ST E
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-2552
Practice Address - Country:US
Practice Address - Phone:612-250-6726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty