Provider Demographics
NPI:1487414686
Name:THREE AFFILIATED TRIBES CHR PROGRAM
Entity type:Organization
Organization Name:THREE AFFILIATED TRIBES CHR PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAEDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-627-4340
Mailing Address - Street 1:307 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:NEW TOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58763-4054
Mailing Address - Country:US
Mailing Address - Phone:701-627-4340
Mailing Address - Fax:701-627-4304
Practice Address - Street 1:24 MINNE TOHE DRIVE
Practice Address - Street 2:
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763
Practice Address - Country:US
Practice Address - Phone:701-627-4340
Practice Address - Fax:701-627-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care