Provider Demographics
NPI:1598000606
Name:NISAKO FAMILY SUPPORT SERVICES
Entity Type:Organization
Organization Name:NISAKO FAMILY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYDEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-703-2901
Mailing Address - Street 1:5201 BRYANT AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55430-3588
Mailing Address - Country:US
Mailing Address - Phone:612-703-2901
Mailing Address - Fax:763-205-2312
Practice Address - Street 1:5201 BRYANT AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55430-3588
Practice Address - Country:US
Practice Address - Phone:612-703-2901
Practice Address - Fax:763-205-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health