Provider Demographics
NPI:1972685568
Name:HENNEPIN COUNTY
Entity Type:Organization
Organization Name:HENNEPIN COUNTY
Other - Org Name:HEALTHCARE FOR THE HOMELESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-348-8824
Mailing Address - Street 1:525 PORTLAND AVE # MC963
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1533
Mailing Address - Country:US
Mailing Address - Phone:612-348-5553
Mailing Address - Fax:
Practice Address - Street 1:525 PORTLAND AVE # MC963
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1533
Practice Address - Country:US
Practice Address - Phone:612-348-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENNEPIN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN166081-D361OtherUCARE
MN735854700Medicaid
MN69-82979OtherEVERCARE
MN48-00068OtherMEDICA
MN102000000018OtherMHP
MN16Y28HEOtherBLUE CROSS BLUE SHIELD
MN35444OtherHEALTHPARTNERS
MN69-82979OtherEVERCARE