Organization
SPIRIT LAKE TRIBE
Active
Other names
Early Childhood Tracking
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY L. CAVANAUGH (TRIBAL CHAIRPERSON)
(701) 381-2006
Entity
Organization
Contact information
Practice address
416 2ND AVENUE NORTH, FORT TOTTEN, ND 58335
(701) 766-1238
(701) 766-1260
Mailing address
416 2ND AVENUE NORTH, PO BOX 489, FORT TOTTEN, ND 58335
(701) 766-1238
(701) 766-1260
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1325
—
ND
Enumeration date
11/17/2006
Last updated
10/09/2019
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