Miles Decora
Individual provider Active NPI Peer Specialist · Devils Lake, ND
NPI 1396546099 · NPPES record last updated Mar 20, 2025
Key facts
- NPI
- 1396546099
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 512 4TH St NE
Devils Lake, ND 58301-2597 - Phone
- (701) 662-6767
- NPI assigned
- Mar 20, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Region Community Shelter | Case Manager/Care Coordinator | Current |
Accepting new patients |
| Amachi Mentoring | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | |||
| Peer Specialist | 175T00000X | Yes | ||
| Case Manager/Care Coordinator |
171M00000X |
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
Other providers in Devils Lake, ND
- Paige Nicole Dahlen
- Danielle Skaar, FNP-C, PLLC
- Lesya Dariychuk
- Leland Davenport
- Audrey Sue Davies
- Brittany Decouteau
- Haeley M. Delahee
- Phillip Delaney
- Amanda Delvo
- Taylin Demarce
All providers in Devils Lake, ND · Peer Specialist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.