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NPI Code Detail

MEDICARE: NORTHWEST HUMAN SERVICE CENTER

MEDICARE: NORTHWEST HUMAN SERVICE CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225051550
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST HUMAN SERVICE CENTER
Provider Business Mailing Address
First Line : PO BOX 1266
Second Line :
City : WILLISTON
State : ND
Zip : 58802-1266
Country : US
Telephone Number : 701-774-4600
Fax Number : 701-774-4620
Provider Business Practice Location Address
First Line : 316 2ND AVE W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-5218
Country : US
Telephone Number : 701-774-4600
Fax Number : 701-774-4620
Authorized Official
Title or Position : DIRECTOR
Name : MRS. LAURIE GOLVASLEE
Credential :
Telephone Number : 701-774-4600
Provider Enumeration Date : 07/26/2006
Last Update Date : 05/15/2014

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Practice Location Address:
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1700813029 — MRS. TANYA M FOX LAC
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1205912805 — MRS. VALERIE WROLSON RN,BSN
Practice Location Address:
316 2ND AVE W
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58801-5218
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Practice Fax: 701-774-4620
1174609671 — RONALD K QUALLEY LAC
Practice Location Address:
316 2ND AVE W
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1285710749 — MRS. HOLLY SNELLINGS LSW
Practice Location Address:
316 2ND AVE W
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Directions to “NORTHWEST HUMAN SERVICE CENTER ” Practice Location

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