Provider Demographics
NPI:1427703933
Name:MENTAL HEALTH AMERICA OF NORTH DAKOTA
Entity type:Organization
Organization Name:MENTAL HEALTH AMERICA OF NORTH DAKOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOTTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-255-3692
Mailing Address - Street 1:523 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4055
Mailing Address - Country:US
Mailing Address - Phone:701-222-3310
Mailing Address - Fax:
Practice Address - Street 1:523 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4055
Practice Address - Country:US
Practice Address - Phone:701-255-3692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health