Healthcare Provider Details

I. General information

NPI: 1174501712
Provider Name (Legal Business Name): COMMUNITY ACTION PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E VILLARD ST
DICKINSON ND
58601-5247
US

IV. Provider business mailing address

202 E VILLARD ST
DICKINSON ND
58601-5247
US

V. Phone/Fax

Practice location:
  • Phone: 701-227-0131
  • Fax: 701-227-4750
Mailing address:
  • Phone: 701-227-0131
  • Fax: 701-227-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateND

VIII. Authorized Official

Name: MR. ERV BREN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 701-227-0131