Provider Demographics
NPI:1093114233
Name:SOUTH CENTRAL ADULT SERVICES COUNCIL INC.
Entity type:Organization
Organization Name:SOUTH CENTRAL ADULT SERVICES COUNCIL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-845-4300
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-0298
Mailing Address - Country:US
Mailing Address - Phone:701-845-4300
Mailing Address - Fax:701-845-4073
Practice Address - Street 1:139 2ND AVE. SE
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072
Practice Address - Country:US
Practice Address - Phone:701-845-4300
Practice Address - Fax:701-845-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND343900000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1463718Medicaid
ND57907Medicaid