Provider Demographics
NPI:1548436090
Name:VOLUNTEERS OF AMERICA MN/WI
Entity type:Organization
Organization Name:VOLUNTEERS OF AMERICA MN/WI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FJELSTUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-225-4052
Mailing Address - Street 1:7625 METRO BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3057
Mailing Address - Country:US
Mailing Address - Phone:952-945-4092
Mailing Address - Fax:888-965-5130
Practice Address - Street 1:9220 BASS LAKE RD STE 255
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-3019
Practice Address - Country:US
Practice Address - Phone:952-945-4052
Practice Address - Fax:888-965-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8105041MHC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN098222900Medicaid
MNC03165OtherMEDICARE PTAN