Organization
LUTHERAN SOCIAL SERVICES OF ND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA THOMMASON (PRESIDENT CEO)
(701) 235-7341
Entity
Organization
Contact information
Practice address
3911 20TH AVE S, FARGO, ND 58103
(701) 235-7341
Mailing address
PO BOX 389, FARGO, ND 58107-0389
(701) 235-7341
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005817398
AETNA
—
05
—
050955
—
ND
01
—
10355
BLUE CROSS BLUE SHIELD ND
ND
01
—
50-50094
MEDICA
—
05
—
54635
—
ND
05
—
55350
—
ND
05
—
57446
—
ND
Enumeration date
05/16/2007
Last updated
04/03/2015
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