Provider Demographics
NPI:1558427708
Name:LIFE SKILLS AND TRANSITION CENTER
Entity Type:Organization
Organization Name:LIFE SKILLS AND TRANSITION CENTER
Other - Org Name:
Other - Org Type:
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 1:701 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1379
Mailing Address - Country:US
Mailing Address - Phone:701-352-4564
Mailing Address - Fax:701-352-4376
Practice Address - Street 1:701 W 6TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1379
Practice Address - Country:US
Practice Address - Phone:701-352-4564
Practice Address - Fax:701-352-4376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND30806Medicaid
ND30806Medicaid