Provider Demographics
NPI:1407042575
Name:WEST CENTRAL COMMUNITY HEALTH CENTER NETWORK
Entity Type:Organization
Organization Name:WEST CENTRAL COMMUNITY HEALTH CENTER NETWORK
Other - Org Name:SANDHILLS COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO CCCHC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-873-7788
Mailing Address - Street 1:1312 HIGHWAY 49 N
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:ND
Mailing Address - Zip Code:58523-6038
Mailing Address - Country:US
Mailing Address - Phone:701-537-2007
Mailing Address - Fax:701-537-5407
Practice Address - Street 1:2 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:TOWNER
Practice Address - State:ND
Practice Address - Zip Code:58788-0156
Practice Address - Country:US
Practice Address - Phone:701-537-2007
Practice Address - Fax:701-537-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center