Provider Demographics
NPI:1558517318
Name:MINNEAPOLIS URBAN LEAGUE
Entity Type:Organization
Organization Name:MINNEAPOLIS URBAN LEAGUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUAMANAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-302-3101
Mailing Address - Street 1:2100 PLYMOUTH AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-3675
Mailing Address - Country:US
Mailing Address - Phone:612-302-3100
Mailing Address - Fax:612-521-1444
Practice Address - Street 1:2100 PLYMOUTH AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3675
Practice Address - Country:US
Practice Address - Phone:612-302-3100
Practice Address - Fax:612-521-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management