Provider Demographics
NPI:1801082847
Name:MISSIONS INC. PROGRAMS
Entity type:Organization
Organization Name:MISSIONS INC. PROGRAMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-559-1883
Mailing Address - Street 1:3409 E MEDICINE LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2307
Mailing Address - Country:US
Mailing Address - Phone:763-559-1883
Mailing Address - Fax:763-559-1195
Practice Address - Street 1:3409 E MEDICINE LAKE BLVD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2307
Practice Address - Country:US
Practice Address - Phone:763-559-1883
Practice Address - Fax:763-559-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8015661-DS251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health