Provider Demographics
NPI:1437196573
Name:BADLANDS HUMAN SERVICE CENTER
Entity Type:Organization
Organization Name:BADLANDS HUMAN SERVICE CENTER
Other - Org Name:BADLANDS HSC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT CFO - DHS
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-328-4924
Mailing Address - Street 1:300 13TH AVE W STE 1
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-4875
Mailing Address - Country:US
Mailing Address - Phone:701-227-7500
Mailing Address - Fax:701-227-7575
Practice Address - Street 1:300 13TH AVE W STE 1
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-4875
Practice Address - Country:US
Practice Address - Phone:701-227-7500
Practice Address - Fax:701-227-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND032321Medicaid