Provider Demographics
NPI:1245546431
Name:ROLFS FOSTER CARE LLC
Entity type:Organization
Organization Name:ROLFS FOSTER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:ROLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-679-5272
Mailing Address - Street 1:2039 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051-7457
Mailing Address - Country:US
Mailing Address - Phone:320-679-5272
Mailing Address - Fax:
Practice Address - Street 1:2039 153RD AVE
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051-7457
Practice Address - Country:US
Practice Address - Phone:320-679-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1057883-1-AFC253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency