SOUTHEAST HUMAN SERVICE CENTER (NPI# 1922055243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922055243 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST HUMAN SERVICE CENTER |
| Practice Address |
2624 9th Ave S Fargo ND 58103-2350 |
| Practice Telephone | 7012984500 |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CANDACE CAE FUGLESTEN (DIRECTOR) |
| Authorized Official Telephone | 7012984500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 035434 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245284850 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-19 |
| 1295256386 | Southeast Human Service Center | Community/Behavioral Health | 2624 9th Ave S, Fargo, ND 58103-2350 | 2017-06-29 |
| 1932146941 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-31 |
| Street Address |
2624 9TH AVE S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-2350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245284850 | Southeast Human Service Center | Clinic/Center | 2624 9th Ave S, Fargo, ND 58103-2350 | 2006-05-19 |
| 1750982120 | Lena Fogel | Counselor | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-11-03 |
| 1356956247 | Carmen Berg | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-09-09 |
| 1225643125 | Heidi Ottmar | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-09-09 |
| 1962011239 | Tayler Wilson | Registered Nurse | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-23 |
| 1023626595 | Jordan Solheim | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-21 |
| 1710595954 | Carissa Bertsch | Registered Nurse | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-14 |
| 1740898923 | Madeline Swanson | Social Worker | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-14 |
| 1821615394 | Tanner Valnes | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-07-01 |
| 1447876446 | Rachael Steinke | Case Manager/Care Coordinator | 2624 9th Ave S, Fargo, ND 58103-2350 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790292274 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 220 North Gilbertson Street, Tioga, ND 58852 | 2018-01-05 |
| 1104332337 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 709 E Eagel Dr, New Town, ND 58763 | 2017-12-26 |
| 1003322231 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 723 2nd Street Sw, Stanley, ND 58784 | 2017-12-26 |
| 1821504051 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 220 N Gilbertson Street, Tioga, ND 58852 | 2017-12-26 |
| 1215442231 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 612 E Broadway, Williston, ND 58801-6104 | 2017-12-13 |
| 1518148394 | Knife River Group Homes, Inc. | Day Training, Developmentally Disabled Services | 508 3rd Ave Nw, Hazen, ND 58545-4503 | 2007-11-20 |
| 1114123106 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 612 East Broadway, Williston, ND 58801-1627 | 2007-06-26 |
| 1912359886 | L.i.s.t.e.n. Inc | Day Training, Developmentally Disabled Services | 1407 24th Ave S, 100, Grand Forks, ND 58201-6761 | 2016-07-05 |
| 1750542478 | Anne Carlsen Center for Children | Day Training, Developmentally Disabled Services | 701 3rd St Nw, Jamestown, ND 58401-2963 | 2008-06-25 |
| 1184801185 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 612 East Broadway, Williston, ND 58801-1627 | 2008-01-22 |
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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.