Organization
TRENTON INDIAN SERVICE AREA
Active
Organization
TRENTON INDIAN SERVICE AREA
Active
Other names
Trenton Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KELCEY LAWRENCE (ERS)
(701) 572-8316
Entity
Organization
Contact information
Practice address
331 4TH AVE E, TRENTON, ND 58853-9998
(701) 774-0461
(701) 774-0461
Mailing address
331 4TH AVE E, TRENTON, ND 58853-9998
(701) 774-0461
(701) 774-8003
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1312
—
ND
01
—
287001
BC/BS OF ND PROVIDER NUM.
ND
01
—
35D0409330
CLIA
ND
Enumeration date
08/31/2006
Last updated
12/30/2024
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