Provider Demographics
NPI:1568212751
Name:INTERFAITH OUTREACH & COMMUNITY PARTNERS
Entity Type:Organization
Organization Name:INTERFAITH OUTREACH & COMMUNITY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-489-7719
Mailing Address - Street 1:1605 COUNTY ROAD 101 N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-2708
Mailing Address - Country:US
Mailing Address - Phone:763-489-7500
Mailing Address - Fax:
Practice Address - Street 1:11229 HWY 55
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-6067
Practice Address - Country:US
Practice Address - Phone:763-340-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management