Organization
SPIRIT LAKE TRIBE
Active
Other names
COMMUNITY HEALTH REPRESENTATIVES, Spirit Lake Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONALD PARISIEN (TRIBAL HEALTH DIRECTOR)
(701) 230-5696
Entity
Organization
Contact information
Practice address
816 3RD AVE N, FORT TOTTEN, ND 58335-9998
(701) 766-4236
(701) 766-4878
Mailing address
816 3RD AVE N, FORT TOTTEN, ND 58335
(701) 766-4236
(701) 766-4878
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
ND
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
ND
261QP0905X
State or Local Public Health Clinic/Center
—
ND
261QP1100X
Podiatric Clinic/Center
—
ND
261QP2300X
Primary Care Clinic/Center
—
ND
261QR0206X
Mammography Clinic/Center
—
ND
291U00000X
Clinical Medical Laboratory
—
ND
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
ND
3416L0300X
Land Ambulance
—
ND
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1466035
—
ND
Enumeration date
04/08/2014
Last updated
04/21/2021
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