Healthcare Provider Details

I. General information

NPI: 1093114233
Provider Name (Legal Business Name): SOUTH CENTRAL ADULT SERVICES COUNCIL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2014
Last Update Date: 05/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 2ND AVE. SE
VALLEY CITY ND
58072
US

IV. Provider business mailing address

PO BOX 298
VALLEY CITY ND
58072-0298
US

V. Phone/Fax

Practice location:
  • Phone: 701-845-4300
  • Fax: 701-845-4073
Mailing address:
  • Phone: 701-845-4300
  • Fax: 701-845-4073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateND

VIII. Authorized Official

Name: PATRICIA ANN HANSEN
Title or Position: DIRECTOR
Credential:
Phone: 701-845-4300