Healthcare Provider Details

I. General information

NPI: 1710359633
Provider Name (Legal Business Name): AID INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2015
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 W MAIN ST
MANDAN ND
58554-3144
US

IV. Provider business mailing address

314 W MAIN ST
MANDAN ND
58554-3144
US

V. Phone/Fax

Practice location:
  • Phone: 701-663-2122
  • Fax: 701-663-7521
Mailing address:
  • Phone: 701-663-2122
  • Fax: 701-663-7521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA ELLEN REGAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 701-663-2122