Provider Demographics
NPI:1154842185
Name:SOUTH CENTRAL HUMAN SERVICE CENTER
Entity Type:Organization
Organization Name:SOUTH CENTRAL HUMAN SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:STENSETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-298-4578
Mailing Address - Street 1:520 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-2968
Mailing Address - Country:US
Mailing Address - Phone:701-253-6400
Mailing Address - Fax:701-253-6400
Practice Address - Street 1:520 3RD ST NW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58402-2055
Practice Address - Country:US
Practice Address - Phone:701-253-6400
Practice Address - Fax:701-253-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND249519Medicaid