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SOUTHEAST HUMAN SERVICE CENTER NPI 1245284850


NPI Information

NPI: 1245284850
Provider Name: SOUTHEAST HUMAN SERVICE CENTER
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
2624 9TH AVE S
FARGO, ND
ZIP 58103
Phone: (701) 298-4500
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SOUTHEAST HUMAN SERVICE CENTER is a developmental disabilities clinic center in Fargo, ND. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). SOUTHEAST HUMAN SERVICE CENTER NPI is 1245284850. The provider is registered as an organization entity type.

The provider's business location address is:

2624 9TH AVE S
FARGO, ND
ZIP 58103-350
Phone: (701) 298-4500

The provider's authorized official is Donna Aukland .
The authorized official title is Assistant Cfo - Dhs and has the following contact phone number (701) 328-4924.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 12/10/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1032318MEDICAIDNORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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