Provider Demographics
NPI:1780236935
Name:SOUTHWEST MULTI-COUNTY CORRECTION CENTER
Entity type:Organization
Organization Name:SOUTHWEST MULTI-COUNTY CORRECTION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WARDEN
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNTUNEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:701-579-5100
Mailing Address - Street 1:440 MCKENZIE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ENGLAND
Mailing Address - State:ND
Mailing Address - Zip Code:58647-7310
Mailing Address - Country:US
Mailing Address - Phone:701-579-5100
Mailing Address - Fax:701-579-5100
Practice Address - Street 1:66 W MUSEUM DR
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-3864
Practice Address - Country:US
Practice Address - Phone:701-456-7728
Practice Address - Fax:701-456-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty