Organization
SPIRIT LAKE TRIBE
Active
Parent organization
SPIRIT LAKE TRIBE
Other names
Spirit Lake Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPIRIT LAKE TRIBE
Authorized official
ARLENE KRULISH (CEO)
(701) 766-1607
Entity
Organization
Contact information
Practice address
3883 74TH AVE NE, FORT TOTTEN, ND 58335
(701) 766-1600
(701) 766-1630
Mailing address
PO BOX 309, FORT TOTTEN, ND 58335-0309
(701) 766-1600
(701) 766-1630
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
08/23/2016
Last updated
04/07/2020
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