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NPI Code Detail

MEDICARE: NORTHWEST BEHAVIORAL HEALTH CLINIC

MEDICARE: NORTHWEST BEHAVIORAL HEALTH CLINIC
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1172ND
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)1172ND
3261QM0855XAdolescent and Children Mental Health Clinic/Center1172ND
4261QM0850XAdult Mental Health Clinic/Center1172ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1156001OTHERNDBCBS OF ND
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770524613
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST BEHAVIORAL HEALTH CLINIC
Provider Business Mailing 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
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 : ASSISTANT CFO - DHS
Name : DONNA AUKLAND
Credential :
Telephone Number : 701-328-4924
Provider Enumeration Date : 06/10/2006
Last Update Date : 03/31/2026

Similar Medicare Providers

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Practice Location Address:
316 2ND AVE W
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1295255933 — NORTHWEST BEHAVIORAL HEALTH CLINIC
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Practice Location Address:
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WILLISTON, ND
58801-5218
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Practice Fax: 701-774-4620
1013620624 — KELVIN HAZANGWI
Practice Location Address:
316 2ND AVE W
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58801-5218
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1245677277 — VIRGINIA A HASS LMSW
Practice Location Address:
316 2ND AVE W
WILLISTON, ND
58801-5218
Practice Phone: 701-774-4600
Practice Fax: 701-774-4620

Directions to “NORTHWEST BEHAVIORAL HEALTH CLINIC ” Practice Location

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