NPIMap

Organization Active NPI

Home on the Range

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Sentinel Butte, ND
National Provider Identifier
1114059805
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
HOME ON THE RANGE
Practice address
16351 I94
Sentinel Butte, ND 58654-9500
Phone
(701) 872-3745
Fax
(701) 872-3748
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Diane Szudera, A.O.
Title
Business Administration Director
Phone
(701) 872-3745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X ND Primary

Addresses

Primary practice location

16351 I94
Sentinel Butte, ND 58654-9500

Mailing address

16351 I94
Sentinel Butte, ND 58654-9500
Phone (701) 872-3745

Other identifiers 5

IdentifierTypeStateIssuer
050603MedicaidND
320399MedicaidMT
1454974MedicaidND
1478591MedicaidND
06887-001OtherNDBS OF ND

National Provider Directory

National Provider Directory

Locations

16351 I94
Sentinel Butte, ND 58654
Phone (701) 872-3745

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114059805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16351 I94",
            "city": "SENTINEL BUTTE",
            "state": "ND",
            "postal_code": "586549500",
            "telephone_number": "701-872-3745",
            "fax_number": "701-872-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16351 I94",
            "city": "SENTINEL BUTTE",
            "state": "ND",
            "postal_code": "586549500",
            "telephone_number": "701-872-3745",
            "fax_number": "701-872-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME ON THE RANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-07-21",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "SZUDERA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATION DIRECTOR",
        "authorized_official_telephone_number": "701-872-3745",
        "authorized_official_credential": "A.O."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050603",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320399",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454974",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1478591",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF ND",
            "identifier": "06887-001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sentinel Butte, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.