NORTHEAST HUMAN SERVICE CENTER (NPI# 1689612475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689612475 |
| Entity Type | Organization |
| Organization Name | NORTHEAST HUMAN SERVICE CENTER |
| Practice Address |
151 S 4th St Suite 401 Grand Forks ND 58201-4715 |
| Practice Telephone | 7017953000 |
| Practice Fax Number | 7017953050 |
| Mailing Telephone | 7017953000 |
| Mailing Fax Number | 7017953050 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. KATHRYN M KENNA (DIRECTOR) |
| Authorized Official Telephone | 7017953014 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BCBSMN GROUP ID | BCBS OF MN | 01 |
| ND | 032317 | 05 | |
| ND | GROUP BCBSNE ID | BCBS OF ND | 01 |
| ND | RR MEDICARE GROUP ID | RAILROAD MEDICARE | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891808978 | Northeast Human Service Center | Residential Treatment Facility, Emotionally Disturbed Children | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2006-08-16 |
| 1366496341 | Northeast Human Service Center | Clinic/Center | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2006-05-22 |
| 1922529932 | Northeast Human Service Center | Community/Behavioral Health | 151 S 4th St Ste 401, Grand Forks, ND 58201-4715 | 2017-06-29 |
| Street Address |
151 S 4TH ST SUITE 401 |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366496341 | Northeast Human Service Center | Clinic/Center | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2006-05-22 |
| 1336752443 | Garett C Wiltse | Counselor | 151 S 4th St, Grand Forks, ND 58201-4715 | 2020-08-28 |
| 1700496775 | Caylee Ellingson | Psychologist | 151 S 4th St, Grand Forks, ND 58201-4715 | 2020-08-05 |
| 1134647530 | Cynthia Severinson | Registered Nurse | 151 S 4th St, Ste 401, Grand Forks, ND 58201 | 2017-09-06 |
| 1194255026 | George C. Jirout | Social Worker | 151 S 4th St, Grand Forks, ND 58201-4715 | 2017-06-13 |
| 1568998391 | Casey Davidson | Social Worker | 151 S 4th St, Suite 201, Grand Forks, ND 58201-4715 | 2017-05-11 |
| 1043745763 | Michelle Marie Tupa | Social Worker | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-05-01 |
| 1740713239 | Sara Bondy | Social Worker | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-04-11 |
| 1184157349 | Erin West | Counselor | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2017-04-05 |
| 1215471362 | Sara K. Munson | Counselor | 151 S 4th St, Suite 401, Grand Forks, ND 58201-4715 | 2016-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| 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.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457521155 | Tri City Cares, Inc | Clinic/Center | 15 1st St Se, Stanley, ND 58784 | 2008-03-10 |
| 1821268517 | Tri City Care, Inc | Clinic/Center | 723 1st St Sw, Stanley, ND 58784 | 2008-03-10 |
| 1669642369 | Tri City Cares, Inc | Clinic/Center | 415 7th Ave Se, Stanley, ND 58784 | 2008-03-10 |
| 1982800959 | Tri City Cares, Inc. | Clinic/Center | 15 1st Street Se, Stanley, ND 58784 | 2007-06-26 |
| 1730212325 | Children's Development Center, Inc. | Clinic/Center | 1815 Schafer St, Ste 202, Bismarck, ND 58501-1217 | 2007-03-13 |
| 1194778944 | South Central Human Service Center | Clinic/Center | 520 3rd St Nw, Jamestown, ND 58401-2968 | 2006-05-19 |
| 1245284850 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-19 |
| 1205293537 | Jmb Services Inc | Clinic/Center | 1911 N 11th St, Bismarck, ND 58501-1915 | 2016-01-17 |
| 1336454438 | Susan Delap, Md, Professional Corporation | Clinic/Center | 4023 State St, Suite 100, Bismarck, ND 58503-0690 | 2010-08-12 |
| 1902076607 | Tri City Care, Inc | Clinic/Center | 15 1st Ave Se, Stanley, ND 58784-9998 | 2008-03-10 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
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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.