Provider Demographics
NPI:1104253020
Name:NORTHERN PLAINS CHILDREN'S ADVOCACY CENTER
Entity type:Organization
Organization Name:NORTHERN PLAINS CHILDREN'S ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NPCAC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:701-852-0836
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-3239
Mailing Address - Country:US
Mailing Address - Phone:701-858-2083
Mailing Address - Fax:701-852-0623
Practice Address - Street 1:20 1ST ST SW STE 202
Practice Address - Street 2:NORTHERN PLAINS CHILDREN'S ADVOCACY CENTER
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-3851
Practice Address - Country:US
Practice Address - Phone:701-852-0836
Practice Address - Fax:701-852-0623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3960251S00000X
ND2198251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1760571285OtherBLUE CROSS BLUE SHIELD
ND19261Medicaid
ND1245329812OtherBLUE CROSS BLUE SHIELD
ND19238Medicaid
ND1760571285OtherBLUE CROSS BLUE SHIELD
ND1245329812Medicare PIN