Organization
NORTHEAST BEHAVIORAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL SLAVENS (REGIONAL DIRECTOR)
(701) 795-3010
Entity
Organization
Contact information
Practice address
151 S 4TH ST STE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3020
Mailing address
151 S 4TH ST STE 401, GRAND FORKS, ND 58201-4715
(701) 795-3000
(701) 795-3020
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ND249517
—
ND
Enumeration date
06/29/2017
Last updated
03/31/2026
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