Provider Demographics
NPI:1285367078
Name:POWER OF STORY
Entity type:Organization
Organization Name:POWER OF STORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATHESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-807-4898
Mailing Address - Street 1:110 E 31ST ST # 8377
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4785
Mailing Address - Country:US
Mailing Address - Phone:763-807-4898
Mailing Address - Fax:
Practice Address - Street 1:110 E 31ST ST # 8377
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4785
Practice Address - Country:US
Practice Address - Phone:763-807-4898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency