Provider Demographics
NPI:1992342513
Name:THE SALVATION ARMY
Entity type:Organization
Organization Name:THE SALVATION ARMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GOVERNMENT GRANTWRITER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:UTHKE-SCALETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED OFFICIAL
Authorized Official - Phone:651-746-3543
Mailing Address - Street 1:2445 PRIOR AVE N
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2714
Mailing Address - Country:US
Mailing Address - Phone:651-746-3400
Mailing Address - Fax:651-746-3546
Practice Address - Street 1:2080 WOODLYNN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1418
Practice Address - Country:US
Practice Address - Phone:651-779-9177
Practice Address - Fax:651-779-5979
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SALVATION ARMY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care