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General NPI Number Information
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NPI Number | 1689758039
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Entity Type | Organization
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Legal Business Name | NORTHLAND HEALTH PARTNERS COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 401 2ND AVE
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City | ROLETTE
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State | ND
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Zip | 58366
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Country | US
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Telephone | 701-246-3391
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Fax | 701-246-3422
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | TURTLE LAKE
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State | ND
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Zip | 58575
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Country | US
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Telephone | 701-448-2054
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RACHEL THOMAS
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Credential |
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Telephone | 701-448-2054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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