Provider Demographics
NPI:1982928347
Name:JOSEPH J. HOUSE EDD LP
Entity Type:Organization
Organization Name:JOSEPH J. HOUSE EDD LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LP
Authorized Official - Phone:763-544-6806
Mailing Address - Street 1:1405 LILAC DR N
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4535
Mailing Address - Country:US
Mailing Address - Phone:763-544-6806
Mailing Address - Fax:763-544-4413
Practice Address - Street 1:1405 LILAC DR N
Practice Address - Street 2:STE 150
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4535
Practice Address - Country:US
Practice Address - Phone:763-544-6806
Practice Address - Fax:763-544-4413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0281103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty