NPIMap

Organization Active NPI

Pride Manchester Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bismarck, ND
National Provider Identifier
1346351475
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
PRIDE MANCHESTER INC.
Practice address
1200 Missouri Ave
Bismarck, ND 58504-5264
Phone
(701) 258-7838
Fax
(701) 258-3735
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Darla Roggenbuck
Title
Financial Coordinator
Phone
(701) 258-7838

Specialties & licenses 1

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

Addresses

Primary practice location

1200 Missouri Ave
Bismarck, ND 58504-5264

Mailing address

1200 Missouri Ave
Bismarck, ND 58504-5264
Phone (701) 258-7838

Other identifiers 1

IdentifierTypeStateIssuer
54382MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Pride Manchester Hope Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1346351475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MISSOURI AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045264",
            "telephone_number": "701-258-7838",
            "fax_number": "701-258-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MISSOURI AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045264",
            "telephone_number": "701-258-7838",
            "fax_number": "701-258-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE MANCHESTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "ROGGENBUCK",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "701-258-7838"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54382",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.