NPIMap

Organization Active NPI

White Earth Band of Ojibwe

Doing business as MOMS Program

  • Community/Behavioral Health Agency
  • Mahnomen, MN
National Provider Identifier
1417316902
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WHITE EARTH BAND OF OJIBWE
Doing business as
MOMS Program
Practice address
2515 Workforce Center Road
Mahnomen, MN 56557
Phone
(218) 936-2442
NPI assigned
Feb 12, 2016
Last updated
Feb 12, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
WHITE EARTH BAND OF OJIBWEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Jeri Jasken
Title
Behavioral Health Director
Phone
(218) 983-4647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2515 Workforce Center Road
Mahnomen, MN 56557

Mailing address

PO Box 70
Naytahwaush, MN 56566-0070
Phone (218) 936-2442

Other names 1

  • MOMS Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
White Earth Oshki Manidoo New Spirit Center26 organizations share this tax ID, including this one
Part of
White Earth Oshki Manidoo New Spirit Center

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1417316902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "NAYTAHWAUSH",
            "state": "MN",
            "postal_code": "565660070",
            "telephone_number": "218-936-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 WORKFORCE CENTER ROAD",
            "city": "MAHNOMEN",
            "state": "MN",
            "postal_code": "56557",
            "telephone_number": "218-936-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE EARTH BAND OF OJIBWE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE EARTH BAND OF OJIBWE",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "JASKEN",
        "authorized_official_first_name": "JERI",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "218-983-4647"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOMS Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mahnomen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.