Provider Demographics
NPI:1932409406
Name:WESTERN COMMUNITIES ACTION NETWORK
Entity type:Organization
Organization Name:WESTERN COMMUNITIES ACTION NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WEYCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-472-0742
Mailing Address - Street 1:2434 COMMERCE BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MOUND
Mailing Address - State:MN
Mailing Address - Zip Code:55364-1456
Mailing Address - Country:US
Mailing Address - Phone:952-472-0742
Mailing Address - Fax:952-472-5589
Practice Address - Street 1:2434 COMMERCE BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MOUND
Practice Address - State:MN
Practice Address - Zip Code:55364-1456
Practice Address - Country:US
Practice Address - Phone:952-472-0742
Practice Address - Fax:952-472-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNES32088251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable