Provider Demographics
NPI:1902846462
Name:CENTRAL VALLEY HEALTH DISTRICT
Entity Type:Organization
Organization Name:CENTRAL VALLEY HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UNIT ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ISZLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:701-252-8130
Mailing Address - Street 1:122 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401
Mailing Address - Country:US
Mailing Address - Phone:701-252-8130
Mailing Address - Fax:701-252-8137
Practice Address - Street 1:122 2ND ST NW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3117
Practice Address - Country:US
Practice Address - Phone:701-252-8130
Practice Address - Fax:701-252-8137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND600000305Medicare ID - Type UnspecifiedRR MEDICARE
NDN70461Medicare ID - Type Unspecified