Provider Demographics
NPI:1174140925
Name:COMMUNITY INTEGRATED FAMILY CARE ADVOCATES
Entity type:Organization
Organization Name:COMMUNITY INTEGRATED FAMILY CARE ADVOCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WREN GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-520-3237
Mailing Address - Street 1:11114 ALMOND DR
Mailing Address - Street 2:
Mailing Address - City:GREY EAGLE
Mailing Address - State:MN
Mailing Address - Zip Code:56336-4643
Mailing Address - Country:US
Mailing Address - Phone:320-527-3237
Mailing Address - Fax:
Practice Address - Street 1:11114 ALMOND DR
Practice Address - Street 2:
Practice Address - City:GREY EAGLE
Practice Address - State:MN
Practice Address - Zip Code:56336-4643
Practice Address - Country:US
Practice Address - Phone:320-527-3237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child