Provider Demographics
NPI:1881211951
Name:NORDELL FAMILY SERVICES LLC
Entity type:Organization
Organization Name:NORDELL FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:NORDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-328-2806
Mailing Address - Street 1:4626 20TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:MN
Mailing Address - Zip Code:55390-5004
Mailing Address - Country:US
Mailing Address - Phone:612-328-2806
Mailing Address - Fax:
Practice Address - Street 1:4626 20TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:MN
Practice Address - Zip Code:55390-5004
Practice Address - Country:US
Practice Address - Phone:612-328-2806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency