Provider Demographics
NPI:1669684825
Name:ABREDEEN AREA TRIBAL CHAIRMANS HEALTH BOARD
Entity Type:Organization
Organization Name:ABREDEEN AREA TRIBAL CHAIRMANS HEALTH BOARD
Other - Org Name:TISA NORTHERN PLAINS HEALTHY START SITE 13
Other - Org Type:Other Name
Authorized Official - Title/Position:TISA NPHS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-774-8824
Mailing Address - Street 1:P.O. BOX 207
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:ND
Mailing Address - Zip Code:58853-0207
Mailing Address - Country:US
Mailing Address - Phone:701-774-8824
Mailing Address - Fax:701-774-1009
Practice Address - Street 1:331 4TH AVE E
Practice Address - Street 2:BUILDING 3
Practice Address - City:TRENTON
Practice Address - State:ND
Practice Address - Zip Code:58853-9998
Practice Address - Country:US
Practice Address - Phone:701-774-8824
Practice Address - Fax:701-774-1009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN PLAINS HEALTHY START
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-03
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No347C00000XTransportation ServicesPrivate Vehicle