Provider Demographics
NPI:1982800959
Name:TRI CITY CARES, INC.
Entity Type:Organization
Organization Name:TRI CITY CARES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:AADNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-628-2990
Mailing Address - Street 1:15 1ST STREET SE
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:ND
Mailing Address - Zip Code:58784
Mailing Address - Country:US
Mailing Address - Phone:701-628-2990
Mailing Address - Fax:701-628-2667
Practice Address - Street 1:15 1ST STREET SE
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:ND
Practice Address - Zip Code:58784
Practice Address - Country:US
Practice Address - Phone:701-628-2990
Practice Address - Fax:701-628-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND30831Medicaid