Organization
RED RIVER BEHAVIORAL HEALTH SYSTEM
Active
Other names
Meridian Behavioral Health LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SMITH (CHIEF ADMINISTRATIVE OFFICER)
(612) 326-7575
Entity
Organization
Contact information
Practice address
1451 44TH AVE S, GRAND FORKS, ND 58201-3434
(701) 772-2500
(701) 757-1512
Mailing address
550 MAIN STREET, SUITE 250, CONTRACTING/CREDENTIALING, GRAND FORKS, ND 58201
(612) 326-7575
(612) 454-2430
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
273R00000X
Psychiatric Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1470202
—
ND
01
—
354005
PART A
ND
01
—
N724902
PART B
ND
Enumeration date
06/24/2016
Last updated
07/20/2020
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