Organization Active NPI

Tri-Valley Opportunity Council

  • Public Health or Welfare Agency
  • Crookston, MN
National Provider Identifier
1104098672
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
R137745-7 Issued in MN
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

Updated by the provider on Mar 25, 2008

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.