Active NPI
Tri-Valley Opportunity Council
- Public Health or Welfare Agency
- Crookston, MN
National Provider Identifier
1104098672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- R137745-7
- Legal business name
- TRI-VALLEY OPPORTUNITY COUNCIL
- Practice address
- 102 N Broadway
Crookston, MN 56716-1731 - Phone
- (218) 281-5832
- Fax
- (218) 281-6676
- NPI assigned
- Mar 25, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cynthia E Boudreaux, RN
- Title
- Health Services Manager
- Phone
- (218) 281-5832
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | R137745-7 | MN | Primary |
Addresses
Primary practice location
102 N Broadway
Crookston, MN 56716-1731
Mailing address
PO Box 607
Crookston, MN 56716-0607
Phone (218) 281-5832
National Provider Directory
National Provider DirectoryLocations
102 N Broadway
Crookston, MN 56716
Phone (218) 281-5832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1206403200000",
"number": "1104098672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 607",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567160607",
"telephone_number": "218-281-5832",
"fax_number": "218-281-6676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 N BROADWAY",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567161731",
"telephone_number": "218-281-5832",
"fax_number": "218-281-6676"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI-VALLEY OPPORTUNITY COUNCIL",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-25",
"last_updated": "2008-03-25",
"status": "A",
"authorized_official_last_name": "BOUDREAUX",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "HEALTH SERVICES MANAGER",
"authorized_official_telephone_number": "218-281-5832",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "MN",
"license": "R137745-7",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crookston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.