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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