Provider Demographics
NPI:1598215295
Name:FAITH IN ACTION FOR CASS COUNTY
Entity Type:Organization
Organization Name:FAITH IN ACTION FOR CASS COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ECLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-675-5435
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:120 WHIPPLE AVE E
Mailing Address - City:HACKENSACK
Mailing Address - State:MN
Mailing Address - Zip Code:56452-0512
Mailing Address - Country:US
Mailing Address - Phone:218-675-5435
Mailing Address - Fax:218-675-5632
Practice Address - Street 1:120 WHIPPLE AVE E
Practice Address - Street 2:SUITE B
Practice Address - City:HACKENSACK
Practice Address - State:MN
Practice Address - Zip Code:56452
Practice Address - Country:US
Practice Address - Phone:218-675-5435
Practice Address - Fax:218-675-5632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable