NPIMap

Organization Active NPI

Village Family Service Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
National Provider Identifier
1548430614
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1142 Issued in ND
Legal business name
VILLAGE FAMILY SERVICE CENTER
Practice address
1201 25TH St S
Fargo, ND 58103-2311
Phone
(701) 451-4900
Fax
(701) 451-4891
NPI assigned
Mar 5, 2008
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Candace Haugen
Title
VP of Human Resources
Phone
(701) 451-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1142 ND Primary

Addresses

Primary practice location

1201 25TH St S
Fargo, ND 58103-2311

Mailing address

1201 25TH St S
Fargo, ND 58103-2311
Phone (701) 451-4900

Other identifiers 3

IdentifierTypeStateIssuer
57527MedicaidND
454484600MedicaidMN
54631MedicaidND

National Provider Directory

National Provider Directory
Tax ID family
Village Family Service Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1548430614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "701-451-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "701-451-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE FAMILY SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "HAUGEN",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "VP OF HUMAN RESOURCES",
        "authorized_official_telephone_number": "701-451-4900"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ND",
            "license": "1142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "57527",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "454484600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54631",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.