NPIMap

Organization Active NPI

Lake Region Community Shelter

  • Case Management Agency
  • Devils Lake, ND
National Provider Identifier
1114673878
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
LAKE REGION COMMUNITY SHELTER
Practice address
512 4TH St NE
Devils Lake, ND 58301-2597
Phone
(701) 665-2797
NPI assigned
Feb 22, 2022
Last updated
May 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Brenda BergsrudNPI 1841914389
Title
Director
Phone
(701) 662-6767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

512 4TH St NE
Devils Lake, ND 58301-2597

Mailing address

414 4TH Ave NE
Devils Lake, ND 58301-2458
Phone (701) 662-6767

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL LRShelter@yahoo.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1114673878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 4TH AVE NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012458",
            "telephone_number": "701-662-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 4TH ST NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012597",
            "telephone_number": "701-665-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION COMMUNITY SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "BERGSRUD",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "701-662-6767"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LRShelter@yahoo.com",
            "affiliation": "N",
            "address_1": "512 4th St NE",
            "city": "Devils Lake",
            "state": "ND",
            "country_code": "US",
            "postal_code": "583012597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.