Provider Demographics
NPI:1427308360
Name:GREATER MINNEAPOLIS CRISIS NURSERY
Entity type:Organization
Organization Name:GREATER MINNEAPOLIS CRISIS NURSERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:796-559-2065
Mailing Address - Street 1:5400 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5120
Mailing Address - Country:US
Mailing Address - Phone:763-591-0400
Mailing Address - Fax:763-591-0700
Practice Address - Street 1:5400 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5120
Practice Address - Country:US
Practice Address - Phone:763-591-0400
Practice Address - Fax:763-591-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health