New Town Health Support Corporation

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

8088 Issued in ND

Legal business name

NEW TOWN HEALTH SUPPORT CORPORATION

Practice address

603 1St Street NW
New Town, ND 58763

Phone

(701) 627-4711

Fax

(701) 627-4013

NPI assigned

Aug 13, 2014

Organization subpart

No

Name

Jeanine Ann Uran

Title

Administrator

Phone

(701) 627-4711

• Lakeside Community Living Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 13, 2014.

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1225437460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-4711",
            "fax_number": "701-627-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 1ST STREET NW",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-4711",
            "fax_number": "701-627-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW TOWN HEALTH SUPPORT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "URAN",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-627-4711"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ND",
            "license": "8088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030792",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Community Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda Medicine Crow
• Suzie F Mesteth, PHN
• Mha Nation Home Health Care
• Scott Lee Mortensen, D.D.S.
• New Town Ambulance Service Inc
• Xaviera Pascale Nyandjo, PHARMD, RPH
• Opportunity Foundation Inc
• John William Pemberton, RPH
• Bridget Peters, DMD
• Shanyce Pienaar, RN

• All providers in New Town, ND
• Assisted Living Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.