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General NPI Number Information
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NPI Number | 1720293301
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Entity Type | Organization
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Legal Business Name | CHARLES HALL YOUTH SERVICES INC.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 513 E BISMARCK EXPY
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City | BISMARCK
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State | ND
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Zip | 58504-6577
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Country | US
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Telephone | 701-255-2773
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Fax | 701-255-6261
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Provider Business Mailing Address
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Address Line | 513 E BISMARCK EXPY
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City | BISMARCK
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State | ND
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Zip | 58504-6577
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Country | US
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Telephone | 701-255-2773
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Fax | 701-255-6261
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GAYLE ROBERT KLOPP
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Credential |
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Telephone | 701-255-2773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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