Provider Demographics
NPI:1174501712
Name:COMMUNITY ACTION PARTNERSHIP
Entity Type:Organization
Organization Name:COMMUNITY ACTION PARTNERSHIP
Other - Org Name:FAMILY PLANNING
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERV
Authorized Official - Middle Name:
Authorized Official - Last Name:BREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-227-0131
Mailing Address - Street 1:202 E VILLARD ST
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5247
Mailing Address - Country:US
Mailing Address - Phone:701-227-0131
Mailing Address - Fax:701-227-4750
Practice Address - Street 1:202 E VILLARD ST
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5247
Practice Address - Country:US
Practice Address - Phone:701-227-0131
Practice Address - Fax:701-227-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND54224Medicaid
ND54224Medicaid