LIFE SKILLS AND TRANSITION CENTER (NPI# 1558427708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558427708 |
| Entity Type | Organization |
| Organization Name | LIFE SKILLS AND TRANSITION CENTER |
| Practice Address |
701 W 6th St Grafton ND 58237-1379 |
| Practice Telephone | 7013524564 |
| Practice Fax Number | 7013524376 |
| Mailing Telephone | 7013524564 |
| Mailing Fax Number | 7013524376 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2013-08-08 |
| Authorized Official Name | CAROL M EBERTOWSKI (DIRECTOR OF FISCAL OPERATIONS) |
| Authorized Official Telephone | 7013524200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30806 | 05 |
| Street Address |
701 W 6TH ST |
| City | GRAFTON |
| State | ND |
| Zip Code | 58237-1379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417932021 | Kathleen R Schweitzer | Nurse Practitioner | 701 W 6th St, Grafton, ND 58237-1379 | 2005-12-07 |
| 1073038436 | Jacy Jane Whaley | Occupational Therapist | 701 W 6th St, Grafton, ND 58237-1379 | 2017-08-07 |
| 1447772207 | Sara Gusaas | Occupational Therapist | 701 W 6th St, Grafton, ND 58237-1379 | 2017-07-13 |
| 1790185239 | Abby West | Dietitian, Registered | 701 W 6th St, Grafton, ND 58237-1379 | 2014-09-03 |
| 1144505231 | Heidi Jo Madsen | Psychologist | 701 W 6th St, Grafton, ND 58237-1379 | 2011-10-20 |
| 1770867517 | Alicia Kerian | Speech-Language Pathologist | 701 W 6th St, Grafton, ND 58237-1379 | 2011-09-28 |
| 1699057489 | Gabriel Saul Waters | Behavioral Analyst | 701 W 6th St, Grafton, ND 58237-1379 | 2011-09-16 |
| 1508148396 | Rick Alan Blair | Behavioral Analyst | 701 W 6th St, Grafton, ND 58237-1379 | 2011-09-16 |
| 1801178694 | Dean Allen Pavlicek | Behavioral Analyst | 701 W 6th St, Grafton, ND 58237-1379 | 2011-09-16 |
| 1306134309 | Jaime Rae Mattson | Nurse Practitioner | 701 W 6th St, Grafton, ND 58237-1379 | 2011-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245748649 | Alissa Lynn Parsons | Case Manager/Care Coordinator | Chase Building, 2nd Floor, 516 Cooper Avenue, Grafton, ND 58237 | 2018-01-19 |
| 1508291626 | Lighthouse Optical Inc. | Technician/Technologist | 317 Cooper Ave, Grafton, ND 58237 | 2013-09-09 |
| 1770893455 | Krystal L Wheeler | Pharmacist | 544 Hill Ave, Grafton, ND 58237 | 2010-10-15 |
| 1174846745 | Michael Goldstone | Emergency Medicine | 6645 154th Ave. Ne, Grafton, ND 58237 | 2010-03-10 |
| 1407067994 | Tara L Shirek | Social Worker | 735 Hill Ave, Suite 203, Grafton, ND 58237 | 2007-05-25 |
| 1679635973 | Michael Anthony Bryan | Counselor | 728 Hill Avenue, Grafton, ND 58237 | 2006-12-14 |
| 1669533394 | Valley Ambulance Service Inc | Ambulance | 1317 Griggs Avenue, Grafton, ND 58237 | 2006-12-13 |
| 1932298544 | White Drug Co of Jamestown Inc | Pharmacy | 737 W 12th St, Grafton, ND 58237 | 2006-10-12 |
| 1649363144 | Developmental Center Pharmacy | Nursing Facility/Intermediate Care Facility | 701 West 6th Street, Grafton, ND 58237 | 2006-10-02 |
| 1043224744 | Upper Valley Special Education | Physical Therapist | 516 Cooper Ave, Grafton, ND 58237 | 2006-07-28 |
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| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316113590 | Villa Nazareth | Intermediate Care Facility, Mentally Retarded | 412 E 10th St, Grafton, ND 58237-1531 | 2008-05-07 |
| 1881648301 | North Dakota Developmental Center | Intermediate Care Facility, Mentally Retarded | 701 W 6th Street, Grafton, ND 58237-1399 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302420 | Lake Region Corporation | Intermediate Care Facility, Mentally Retarded | 2017 Highway 20, Devils Lake, ND 58301-8650 | 2020-06-29 |
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1689197493 | Rem North Dakota | Intermediate Care Facility, Mentally Retarded | 1905 2nd Street Se, Suite 1a, Minot, ND 58701 | 2017-07-24 |
| 1548782790 | 1150 Group Home | Intermediate Care Facility, Mentally Retarded | 1150 N. Collins Aveue, Mandan, ND 58554 | 2017-07-10 |
| 1437690609 | 1140 Grouphome | Intermediate Care Facility, Mentally Retarded | 1140 Collins Ave, Mandan, ND 58554 | 2017-03-20 |
| 1861810053 | Red River Human Services Foundation | Intermediate Care Facility, Mentally Retarded | 903 Mulberry Ln, West Fargo, ND 58078-5000 | 2014-04-03 |
| 1144582933 | Anne Carlsen Center | Intermediate Care Facility, Mentally Retarded | 701 3rd Steeet Nw, Jamestown, ND 58401 | 2012-06-08 |
| 1578835641 | Hit Inc. 1301 Grouphome | Intermediate Care Facility, Mentally Retarded | 1301 7th Ave Se, Mandan, ND 58554 | 2012-02-03 |
| 1598062143 | 1201 Grouphome | Intermediate Care Facility, Mentally Retarded | 1201 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
| 1407153059 | 1203 Grouphome | Intermediate Care Facility, Mentally Retarded | 1203 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.