Provider Demographics
NPI:1811228133
Name:FAMILY CONNECTIONS COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:FAMILY CONNECTIONS COUNSELING CENTER LLC
Other - Org Name:FAMILY CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ARENDT
Authorized Official - Suffix:
Authorized Official - Credentials:LISCW
Authorized Official - Phone:612-716-2828
Mailing Address - Street 1:11608 WAYZATA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-2009
Mailing Address - Country:US
Mailing Address - Phone:952-544-0964
Mailing Address - Fax:952-544-6405
Practice Address - Street 1:11608 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-2009
Practice Address - Country:US
Practice Address - Phone:952-544-0964
Practice Address - Fax:952-544-6405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15568251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health