Provider Demographics
NPI:1972188308
Name:DACOTAH FOUNDATION
Entity Type:Organization
Organization Name:DACOTAH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:EICHELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-220-7842
Mailing Address - Street 1:600 S 2ND ST STE 308
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5729
Mailing Address - Country:US
Mailing Address - Phone:701-223-4517
Mailing Address - Fax:701-223-5775
Practice Address - Street 1:600 S 2ND ST STE 308
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5729
Practice Address - Country:US
Practice Address - Phone:701-223-4517
Practice Address - Fax:701-223-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health