LAKE REGION HUMAN SERVICE CENTER NPI 1669411930

NPI Information

NPI: 1669411930
Provider Name: LAKE REGION HUMAN SERVICE CENTER
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 35D2143777

Address:
200 HIGHWAY 2 W
DEVILS LAKE, ND
ZIP 58301
Phone: (701) 665-2200
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LAKE REGION HUMAN SERVICE CENTER is a mental health (including community mental health center) clinic center in Devils Lake, ND. LAKE REGION HUMAN SERVICE CENTER NPI is 1669411930. The provider is registered as an organization entity type.

The provider's business location address is:

200 HIGHWAY 2 W
DEVILS LAKE, ND
ZIP 58301-532
Phone: (701) 665-2200
Fax: (701) 665-2300

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 CLIA number assigned to this NPI record is 35D2143777 - other - human service center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2006 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
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes
2	261QM0850X	Clinic/Center	Adult Mental Health			No
3	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	1013	NORTH DAKOTA	No

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
1	159001	OTHER	NORTH DAKOTA	BCBS GROUP ID
2	CG8826	OTHER	NORTH DAKOTA	RAILROAD MEDICARE ID
3	054518	MEDICAID	NORTH 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: 4/28/2024

NPI Synchronization or Removal

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