Red River Behavioral Health System

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

RED RIVER BEHAVIORAL HEALTH SYSTEM

Doing business as

Meridian Behavioral Health LLC

Practice address

1451 44TH Ave S
Grand Forks, ND 58201-3434

Phone

(701) 772-2500

Fax

(701) 757-1512

NPI assigned

Jun 24, 2016

Organization subpart

No

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

Authorized official

Name

Mr. James Smith

Title

Chief Administrative Officer

Phone

(612) 326-7575

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Meridian Behavioral Health LLC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 354005

Legal name

RED RIVER BEHAVIORAL HEALTH SYSTEM

Certification status

Terminated Voluntary: merger or closure, Sep 13, 2020

Provider type (POS)

Hospital – Psychiatric

Participating since

Sep 14, 2000

Last certification

Feb 21, 2013

Beds

70

Ownership / control type

Private (for profit)

Most recent change of ownership

Nov 12, 2016 (3 total)

Facility address

1451 44TH Avenue S
Grand Forks, ND 58201

Locations

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1174974877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN STREET",
            "address_2": "SUITE 250, CONTRACTING/CREDENTIALING",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "612-326-7575",
            "fax_number": "612-454-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-772-2500",
            "fax_number": "701-757-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER BEHAVIORAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-24",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "612-326-7575",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART A",
            "identifier": "354005",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B",
            "identifier": "N724902",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1470202",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Behavioral Health LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meridian Behavioral Health LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serena E Ratzlaff, MS, SLP
• Narendra Nath Ravi, M.D
• Jon F Raymond, MD
• Laura A Raymond, MD
• Stephanie Raza
• Red River Family Chiropractic, PC
• Red River Neurology Clinic
• Red River Stepping Stones
• Camille Redmann, LCSW
• Rehabauthority, LLC

• Psychiatric Hospital in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Psychiatric Hospital in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.