Provider Demographics
NPI:1437896552
Name:FAWKES HOUSING SERVICES
Entity type:Organization
Organization Name:FAWKES HOUSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-462-8744
Mailing Address - Street 1:12760 ABERDEEN ST NE STE 304
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5845
Mailing Address - Country:US
Mailing Address - Phone:612-707-9333
Mailing Address - Fax:763-333-1541
Practice Address - Street 1:12760 ABERDEEN ST NE STE 304
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5845
Practice Address - Country:US
Practice Address - Phone:612-707-9333
Practice Address - Fax:763-333-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management