Provider Demographics
NPI:1912220708
Name:CROW RIVER FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:CROW RIVER FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:320-774-3355
Mailing Address - Street 1:1521 NORTHWAY DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1274
Mailing Address - Country:US
Mailing Address - Phone:320-774-3355
Mailing Address - Fax:320-323-3000
Practice Address - Street 1:1521 NORTHWAY DR STE 110
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1274
Practice Address - Country:US
Practice Address - Phone:320-774-3355
Practice Address - Fax:320-323-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty