Provider Demographics
NPI:1255437315
Name:THE FAMILY LINK OF MOORHEAD LLC
Entity type:Organization
Organization Name:THE FAMILY LINK OF MOORHEAD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:WIGAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-477-0333
Mailing Address - Street 1:1012 18TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-1449
Mailing Address - Country:US
Mailing Address - Phone:218-477-0333
Mailing Address - Fax:218-477-0098
Practice Address - Street 1:1012 18TH AVE N
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-1449
Practice Address - Country:US
Practice Address - Phone:218-477-0333
Practice Address - Fax:218-477-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health