Provider Demographics
NPI:1679393045
Name:MISSIONS INC. PROGRAMS
Entity type:Organization
Organization Name:MISSIONS INC. PROGRAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STAFFORD
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-334-7904
Mailing Address - Street 1:3409 E MEDICINE LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2395
Mailing Address - Country:US
Mailing Address - Phone:763-559-1883
Mailing Address - Fax:763-559-1195
Practice Address - Street 1:2759 LOUISIANA CT S APT 8
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3117
Practice Address - Country:US
Practice Address - Phone:952-926-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management