Provider Demographics
NPI:1932261377
Name:POWER OF RELATIONSHIPS
Entity Type:Organization
Organization Name:POWER OF RELATIONSHIPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LP
Authorized Official - Phone:612-221-2441
Mailing Address - Street 1:14329 ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2230
Mailing Address - Country:US
Mailing Address - Phone:612-221-2441
Mailing Address - Fax:612-874-6745
Practice Address - Street 1:820 LILAC DR N
Practice Address - Street 2:SUITE 130
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4700
Practice Address - Country:US
Practice Address - Phone:612-874-6746
Practice Address - Fax:612-874-6745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3544251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN136564OtherUCARE-MN IND NUMBER
MN446316100Medicaid
MN446316101Medicaid
MN84-63537OtherMEDICA
MN136560OtherUCARE-MN
MN26A03POOtherBLUE CROSS GROUP NMBER
MN990223002OtherMHP
MN45291OtherHEALTH PARTNERS