Provider Demographics
NPI:1487708616
Name:THE FAMILY PARTNERSHIP
Entity type:Organization
Organization Name:THE FAMILY PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:TILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-729-0340
Mailing Address - Street 1:1527 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-6700
Mailing Address - Country:US
Mailing Address - Phone:612-729-0340
Mailing Address - Fax:612-728-2095
Practice Address - Street 1:1527 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-6700
Practice Address - Country:US
Practice Address - Phone:612-728-2061
Practice Address - Fax:612-728-2095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8017681MHC251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN929725100Medicaid
MNC02026Medicare ID - Type UnspecifiedSH
MN929725100Medicaid
MNC02223Medicare ID - Type UnspecifiedNH
C01915Medicare PIN