NPIMap

Organization Active NPI

Community Options for Residential and Employment Services, Inc

  • Case Manager/Care Coordinator
  • Bismarck, ND
National Provider Identifier
1356951503
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
COMMUNITY OPTIONS FOR RESIDENTIAL AND EMPLOYMENT SERVICES, INC
Practice address
4909 Shelburne St
Bismarck, ND 58503
Phone
(701) 223-2417
NPI assigned
Aug 3, 2020
Last updated
Apr 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Mr. Bryan L Wetch
Title
Chief Executive Officer
Phone
(701) 223-2417

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Social Worker 104100000X NU
Case Management Agency 251B00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Private Vehicle 347C00000X NU
Case Manager/Care Coordinator 171M00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU
Peer Specialist 175T00000X NU

Addresses

Primary practice location

4909 Shelburne St
Bismarck, ND 58503

Mailing address

4909 Shelburne St
Bismarck, ND 58503
Phone (701) 223-2417

Other practice location 1

425 College Dr S Ste 8
Devils Lake, ND 58301-3537
Phone (701) 223-2417

Other practice location 2

300 3rd Ave SW Ste D
Minot, ND 58701-4346
Phone (701) 223-2417

Other practice location 3

420 20th St SW
Jamestown, ND 58401-6227
Phone (701) 223-2417

Other practice location 4

309 Washington Ave Ste 402
Williston, ND 58801-5242
Phone (701) 223-2417

Other practice location 5

193 24th St E Ste 103
Dickinson, ND 58601-6580
Phone (701) 223-2417

Other practice location 6

2701 9th Ave S Ste E
Fargo, ND 58103-8712
Phone (701) 223-2417

Other practice location 7

1405 Library Cir
Grand Forks, ND 58201-6317
Phone (701) 223-2417

Other identifiers 3

IdentifierTypeStateIssuer
1481175MedicaidND
1481875MedicaidND
1481150MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Community Options for Residential and Employment Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4909 Shelburne St
Bismarck, ND 58503
Phone (701) 381-9927

425 College Dr S
Ste 8
Devils Lake, ND 58301
Phone (701) 662-3110

2701 9th Ave S
Ste E
Fargo, ND 58103
Phone (701) 319-6327

1405 Library Cir
Grand Forks, ND 58201
Phone (701) 330-8552

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1356951503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-223-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-223-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 College Dr S Ste 8",
            "address_purpose": "LOCATION",
            "city": "Devils Lake",
            "state": "ND",
            "postal_code": "583013537",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 3rd Ave SW Ste D",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587014346",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 20th St SW",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "ND",
            "postal_code": "584016227",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 Washington Ave Ste 402",
            "address_purpose": "LOCATION",
            "city": "Williston",
            "state": "ND",
            "postal_code": "588015242",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "193 24th St E Ste 103",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "586016580",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 9th Ave S Ste E",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581038712",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 Library Cir",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582016317",
            "country_code": "US",
            "telephone_number": "701-223-2417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY OPTIONS FOR RESIDENTIAL AND EMPLOYMENT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "WETCH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "701-223-2417",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481175",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481875",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481150",
            "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 Apr 26, 2021; 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.