Provider Demographics
NPI:1255469631
Name:COUNTY OF SARGENT
Entity Type:Organization
Organization Name:COUNTY OF SARGENT
Other - Org Name:SARGENT COUNTY DISTRICT HEALTH UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-724-3725
Mailing Address - Street 1:316 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FORMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58032
Mailing Address - Country:US
Mailing Address - Phone:701-724-3725
Mailing Address - Fax:701-724-3296
Practice Address - Street 1:316 MAIN STREET
Practice Address - Street 2:
Practice Address - City:FORMAN
Practice Address - State:ND
Practice Address - Zip Code:58032
Practice Address - Country:US
Practice Address - Phone:701-724-3725
Practice Address - Fax:701-724-3296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND57995Medicaid
ND57995Medicaid