RICHARD P STADTER PSYCHIATRIC CENTER, LLC (NPI# 1831137389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831137389 |
| Entity Type | Organization |
| Organization Name | RICHARD P STADTER PSYCHIATRIC CENTER, LLC |
| Practice Address |
1451 44th Ave S Ste A Grand Forks ND 58201-3434 |
| Mailing Address |
1451 44th Ave S Po Box 14354 Grand Forks ND 58201-3434 |
| Practice Telephone | 7017722500 |
| Practice Fax Number | 7017878996 |
| Mailing Telephone | 7017722500 |
| Mailing Fax Number | 7017322685 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2015-06-24 |
| Authorized Official Name | DR. THOMAS PETERSON (PRESIDENT/ CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 7017722500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | 5066A | ND | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 01426 | 05 | |
| ND | NDBCBS | 12039 | 01 |
| MN | MNBCBS | 2F78HRI | 01 |
| MN | 712617400 | 05 |
| Street Address |
1451 44TH AVE S STE A |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-3434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620840 | Agnes Olaolu Olowolagba | Nurse Practitioner | 1451 44th Ave S Ste A, Grand Forks, ND 58201-3434 | 2020-02-07 |
| 1720484918 | Tera Jo Field | Nurse Practitioner | 1451 44th Ave S Ste A, Grand Forks, ND 58201-3434 | 2014-11-14 |
| 1336490762 | John Gerard Miller | Counselor | 1451 44th Ave S Ste A, Grand Forks, ND 58201-3434 | 2012-09-25 |
| 1194053637 | Kelly Pratt | Registered Nurse | 1451 44th Ave S Ste A, Grand Forks, ND 58201-3434 | 2009-11-20 |
| 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 | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417901000 | Prairie St Johns | Psychiatric Hospital | 510 4th St S, Fargo, ND 58103-1914 | 2006-05-19 |
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on RICHARD P STADTER PSYCHIATRIC CENTER, LLC.
| 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.