Provider Demographics
NPI:1396982161
Name:70177WAHUS CONSULTING, INC
Entity type:Organization
Organization Name:70177WAHUS CONSULTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:WAHUS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, NCACII, SAP
Authorized Official - Phone:701-572-7217
Mailing Address - Street 1:901 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4810
Mailing Address - Country:US
Mailing Address - Phone:701-572-7217
Mailing Address - Fax:
Practice Address - Street 1:901 6TH ST W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4810
Practice Address - Country:US
Practice Address - Phone:701-572-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1204251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health