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Organization

HEART RIVER SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN H. WIEGLENDA LAC (LAC)
(701) 483-0795
Entity
Organization

Contact information

Practice address
ST JOE'S PLAZA, 30 7TH ST W, DICKINSON, ND 58601-4335
(701) 483-0795
(701) 483-0947
Mailing address
30 7TH ST W, DICKINSON, ND 58601-4335
(701) 483-0795
(701) 483-0947

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1071
ND
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
1071
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11608
BC/BS PROVIDER #
ND
05
146339
ND
05
146341
ND
05
1473659
ND
01
4626
BCBS
ND
Enumeration date
09/16/2006
Last updated
04/15/2026
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